Summary & Overview
CPT 50385: Transurethral Ureteral Stent Removal and Replacement
CPT code 50385 covers transurethral removal and replacement of an internally dwelling ureteral stent performed with imaging guidance and without endoscopic instrumentation. This procedure is commonly performed to manage ureteral obstruction, stent malfunction, or to exchange indwelling stents, and it matters nationally because it affects surgical workflow, site-of-service decisions, and payment policies across outpatient settings. Payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical and procedural scope of the code, typical sites of service, and common modifiers associated with billing for this service. The publication provides benchmarking context and policy-relevant considerations related to coding and site-of-service classification, along with clinical context that clarifies when a transurethral, image-guided approach without endoscopy is reported. Where input data is absent, the summary notes those gaps: associated taxonomies, specific ICD-10 diagnoses, and related codes are not available in the input. This national overview is intended to help coding professionals, payers, and health system administrators understand the fundamental use and reporting considerations for CPT code 50385.
Billing Code Overview
CPT code 50385 describes the removal and replacement of an internally dwelling ureteral stent performed via a transurethral approach with imaging guidance. The procedure is accomplished without the use of an endoscope.
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Service type: Stent removal and replacement (transurethral, image-guided)
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Typical site of service: Ambulatory surgery center or hospital outpatient department where image guidance is available for transurethral urinary tract procedures.
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with an indwelling ureteral stent placed for ureteral obstruction or after ureteroscopy who requires planned exchange to prevent encrustation or relieve symptoms. The patient arrives to an outpatient endoscopy or ambulatory surgery center after pre-procedure assessment including medication reconciliation and consent. Imaging confirmation (fluoroscopy) is available in the procedure room. Under moderate sedation or monitored anesthesia care, the provider performs a transurethral removal and replacement of the ureteral stent using cystoscopic access instruments only for catheter guidance as needed, but without use of an endoscope to directly visualize the ureter (procedure performed using imaging guidance instead). Post-procedure, stent position is confirmed with imaging, the patient is observed for recovery, and discharge instructions address stent-related symptoms, signs of infection, and follow-up for definitive stent removal or further urologic care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default when no special circumstances apply |
11 | Emergency/unscheduled | Use when procedure is performed for an emergency indication rather than scheduled |
22 | Increased procedural services | Use when work or complexity substantially exceeds usual for the procedure |
23 | Unusual anesthesia | Use when general anesthesia is medically necessary for an otherwise typically non-anesthetized procedure |
50 | Bilateral procedure | Use if bilateral ureteral stent procedures are reported and payer accepts bilateral modifier |
52 | Reduced services | Use when the service was partially reduced or not completed as originally planned |
53 | Discontinued procedure | Use when procedure is initiated but aborted for patient-related reasons |
62 | Two surgeons | Use when two surgeons work together as primary surgeons |
66 | Principal surgeon identical to co-surgeon | Use when reporting administrative identification of shared surgical responsibility |
78 | Unplanned return to OR | Use when a return to the operating room for related procedure occurs during the postoperative period |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Urology | Primary specialty performing ureteral stent placement and exchanges |
| 208800000X | Female Pelvic Medicine & Reconstructive Surgery | May perform urologic procedures involving ureteral stents in complex cases |
| 207R00000X | Physician Assistant | Common assisting provider in ambulatory urology procedures |
| 363L00000X | Registered Nurse Anesthetist | Provides monitored anesthesia care or anesthesia services for outpatient procedures |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N13.2 | Hydronephrosis with renal and ureteral calculous obstruction | Ureteral stents commonly used to relieve obstruction from stones |
N13.6 | Pyonephrosis | Stent exchange may be needed to drain infected obstructed systems |
N13.8 | Other obstructive and reflux uropathy | General obstruction indications for stent placement and exchange |
N20.0 | Calculus of kidney | Stones can necessitate stent placement pre- or post-definitive stone treatment |
N20.1 | Calculus of ureter | Ureteral stones frequently require stenting during management |
N39.0 | Urinary tract infection, site not specified | Infection can complicate indwelling stents and prompt exchange |
Z96.0 | Presence of urogenital implants and grafts | Identifies presence of a ureteral stent or other urologic implant requiring management |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
52000 | Cystourethroscopy, diagnostic; with or without collection of specimen(s) by brushing or washing | May be performed prior to stent exchange to evaluate bladder/urethra or to assist catheter access |
52005 | Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography | Used when selective ureteral catheterization is necessary during stent management with contrast studies |
52332 | Cystourethroscopy, with ureteroscopy, with or without manipulation of calculus; with ureteral stent placement (e.g., Gibbons or double-J) | Performed when direct ureteroscopy and stent placement are required instead of imaging-only exchange |
52310 | Cystourethroscopy, with removal of foreign body, calculus, or stent from ureter or kidney | Codes for removal of stents or foreign bodies when endoscopic techniques are used |
76000 | Fluoroscopy (image guidance), any method | Commonly used imaging guidance code to document fluoroscopic guidance during stent exchange |
51701 | Insertion of temporary indwelling bladder catheter; simple (e.g., straight or Foley) | May be used intra- or post-procedurally for bladder drainage or access |