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CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

CPT code 50396 represents a focused diagnostic procedure to measure urinary tract pressures by connecting an indwelling ureteral catheter or an existing nephrostomy or pyelostomy tube to a manometer. It is used to detect obstruction, blockage, or dilatation of the upper urinary tract and informs clinical decisions about urinary drainage and intervention. Nationally, this procedure is relevant for hospitals and ambulatory centers that manage percutaneous and indwelling urinary access devices and for clinicians assessing renal outflow dynamics.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis addresses payment benchmarks, coding guidance, common clinical indications, and typical sites of service for this diagnostic manometry procedure. Readers will find benchmarks for reimbursement and utilization patterns where available, a summary of clinical context and indications, and notes on documentation and coding considerations that support accurate billing. Data not available in the input is noted where applicable. The content is written for a national audience and is intended to inform coding, billing, and administrative staff, as well as clinicians involved in urologic diagnostic services.

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Billing Code Overview

CPT code 50396 describes a diagnostic pressure measurement procedure in which a provider connects an indwelling ureteral catheter or an existing nephrostomy or pyelostomy tube to a manometer line to measure fluid pressures or pressure differentials between the renal pelvis and ureter. The procedure is performed to evaluate obstruction, blockage, or dilatation of the upper urinary tract.

Service type: Diagnostic urologic pressure measurement
Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient setting where existing nephrostomy, pyelostomy, or ureteral catheters are managed and manometry can be performed

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CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

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Billing Code Overview

Service type: Diagnostic urologic pressure measurement
Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient setting where existing nephrostomy, pyelostomy, or ureteral catheters are managed and manometry can be performed

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old male with a history of recurrent flank pain and hydronephrosis found on renal ultrasound. The patient has an indwelling ureteral stent placed previously for ureteral obstruction from a ureteral stone and persistent flank discomfort. The urology team schedules a renal pelvis pressure measurement using a manometer connected to the existing ureteral catheter to assess for residual obstruction and to quantify pelvic pressure prior to definitive intervention.

Workflow: The patient arrives to the outpatient endoscopy suite or hospital radiology/interventional fluoroscopy unit. The existing ureteral catheter or nephrostomy tube is inspected and prepped using sterile technique. A manometer line is connected to the external port of the indwelling ureteral stent or nephrostomy/pyelostomy tube. Baseline pressures are recorded with the patient in a standardized position, then with provocative maneuvers or contrast instillation as indicated. Findings documenting elevated renal pelvic pressures or pressure differentials between kidney and bladder are recorded in the procedure note. The clinician disconnects the manometer, secures the catheter, and documents indications, measurements, and any immediate complications before patient discharge or transfer for further management.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation component separate from technical services.
`50`	Bilateral procedure	If pressure measurements are obtained from both kidneys during the same session and payer allows bilateral modifier use.
`51`	Multiple procedures	When this service is billed with multiple distinct procedures on the same day and payer requires modifier for multiple procedures billing.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances or patient safety.
`59`*	Distinct procedural service	Not in provided list — Data not available in the input.
`62`	Two surgeons	When two surgeons are required to perform the procedure concurrently.
`76`*	Repeat procedure by same physician	Not in provided list — Data not available in the input.
`78`	Return to operating room for a related procedure during postoperative period	When the patient returns to the OR for a related intervention during the global period.
`79`*	Unrelated procedure by the same physician during postoperative period	Not in provided list — Data not available in the input.
`TC`	Technical component	When only the technical component (facility, equipment) is billed by the facility.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Only applicable when anesthesia services are billed with this procedure and the physician is directing.
`QX`	CRNA service with medical direction	When a CRNA provides anesthesia under medical direction during the procedure.
`RT`	Right side	When documenting laterality for the right kidney if payer requires laterality modifiers.
`LT`*	Left side	Not in provided list — Data not available in the input.

Associated Provider Taxonomies

Taxonomy Code	Specialty	Notes
207VF0000X	Urology	Urologists commonly perform or supervise renal pelvic pressure measurements and manage upper urinary tract obstruction.
2080P0206X	Interventional Radiology	Interventional radiologists perform pressure measurements when accessing nephrostomy or pyelostomy tubes in radiology suites.
363L00000X	Anesthesiology	Anesthesiologists or CRNAs may provide monitored anesthesia care or sedation for uncomfortable patients.
207VP0002X	Pediatric Urology	Pediatric urologists perform similar measurements in pediatric patients with congenital obstruction.
341600000X	Diagnostic Radiology	Diagnostic radiologists may be involved when imaging guidance or contrast-assisted pressure dynamics are performed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.30`	Unspecified hydronephrosis	Hydronephrosis is a primary indication for measuring renal pelvic pressures to assess obstruction severity.
`N13.39`	Other hydronephrosis	Alternative hydronephrosis coding for upper urinary tract dilatation assessment with pressure measurement.
`N13.2`	Hydronephrosis with ureteral stricture	Ureteral strictures can produce pressure differentials measured through a manometer connected to a ureteral catheter.
`N20.0`	Calculus of kidney	Nephrolithiasis causing obstruction may prompt pelvic pressure measurement to evaluate functional impact.
`N25.0`	Postrenal renal failure	Elevated renal pelvic pressures contributing to postrenal acute kidney injury are assessed with this procedure.
`N28.1`	Tubulo-interstitial nephritis, not elsewhere classified	Included when obstruction-related backpressure contributes to renal parenchymal changes and evaluation is needed.
`R31.0`	Gross hematuria	Hematuria with suspected obstructive causes may lead to pressure assessment in the upper tract.
`Q62.0`	Unspecified congenital hydronephrosis	Pediatric or congenital causes of dilation warrant pressure measurement to guide management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52005`	Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service	Performed prior to manometric measurement when direct ureteral catheter placement or cystoscopic access is required.
`50390`	Nephrostomy, percutaneous, with or without imaging guidance; initial placement	Performed when creation of a nephrostomy tube is necessary prior to connecting a manometer for renal pelvic pressure measurement.
`50545`	Pyelostomy or nephrostomy, tube or catheter placement, percutaneous; percutaneous placement of drainage catheter	Related when a new pyelostomy or nephrostomy tube is placed and subsequent pressure measurements are needed.
`51702`	Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual urine)	May be performed to evaluate bladder dynamics concurrently with renal pelvic pressure testing.
`99213`	Office or other outpatient visit, established patient, typically 15 minutes	Represents typical evaluation and management visit for pre- and post-procedure assessment when billed separately.

CPT 50390: Renal Cyst Aspiration with Sclerotherapy

CPT-50391-THERAPEUTIC-INSTILLATION-RENAL-PELVIS-URETER

CPT 50391: Therapeutic Instillation into Renal Pelvis or Ureter

CPT-50436-PERCUTANEOUS-NEPHROSTOMY-TRACT-DILATION

CPT 50436: Dilation of Percutaneous Nephrostomy Tract, With Possible Tube Placement

CPT-50437-PERCUTANEOUS-NEPHROSTOMY-TRACT-DILATION-AND-CREATION

CPT 50437: Percutaneous Nephrostomy Tract Dilation with New Tract Creation

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation component separate from technical services.
`50`	Bilateral procedure	If pressure measurements are obtained from both kidneys during the same session and payer allows bilateral modifier use.
`51`	Multiple procedures	When this service is billed with multiple distinct procedures on the same day and payer requires modifier for multiple procedures billing.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances or patient safety.
`59`*	Distinct procedural service	Not in provided list — Data not available in the input.
`62`	Two surgeons	When two surgeons are required to perform the procedure concurrently.
`76`*	Repeat procedure by same physician	Not in provided list — Data not available in the input.
`78`	Return to operating room for a related procedure during postoperative period	When the patient returns to the OR for a related intervention during the global period.
`79`*	Unrelated procedure by the same physician during postoperative period	Not in provided list — Data not available in the input.
`TC`	Technical component	When only the technical component (facility, equipment) is billed by the facility.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Only applicable when anesthesia services are billed with this procedure and the physician is directing.
`QX`	CRNA service with medical direction	When a CRNA provides anesthesia under medical direction during the procedure.
`RT`	Right side	When documenting laterality for the right kidney if payer requires laterality modifiers.
`LT`*	Left side	Not in provided list — Data not available in the input.

Associated Provider Taxonomies

Taxonomy Code	Specialty	Notes
207VF0000X	Urology	Urologists commonly perform or supervise renal pelvic pressure measurements and manage upper urinary tract obstruction.
2080P0206X	Interventional Radiology	Interventional radiologists perform pressure measurements when accessing nephrostomy or pyelostomy tubes in radiology suites.
363L00000X	Anesthesiology	Anesthesiologists or CRNAs may provide monitored anesthesia care or sedation for uncomfortable patients.
207VP0002X	Pediatric Urology	Pediatric urologists perform similar measurements in pediatric patients with congenital obstruction.
341600000X	Diagnostic Radiology	Diagnostic radiologists may be involved when imaging guidance or contrast-assisted pressure dynamics are performed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.30`	Unspecified hydronephrosis	Hydronephrosis is a primary indication for measuring renal pelvic pressures to assess obstruction severity.
`N13.39`	Other hydronephrosis	Alternative hydronephrosis coding for upper urinary tract dilatation assessment with pressure measurement.
`N13.2`	Hydronephrosis with ureteral stricture	Ureteral strictures can produce pressure differentials measured through a manometer connected to a ureteral catheter.
`N20.0`	Calculus of kidney	Nephrolithiasis causing obstruction may prompt pelvic pressure measurement to evaluate functional impact.
`N25.0`	Postrenal renal failure	Elevated renal pelvic pressures contributing to postrenal acute kidney injury are assessed with this procedure.
`N28.1`	Tubulo-interstitial nephritis, not elsewhere classified	Included when obstruction-related backpressure contributes to renal parenchymal changes and evaluation is needed.
`R31.0`	Gross hematuria	Hematuria with suspected obstructive causes may lead to pressure assessment in the upper tract.
`Q62.0`	Unspecified congenital hydronephrosis	Pediatric or congenital causes of dilation warrant pressure measurement to guide management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52005`	Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service	Performed prior to manometric measurement when direct ureteral catheter placement or cystoscopic access is required.
`50390`	Nephrostomy, percutaneous, with or without imaging guidance; initial placement	Performed when creation of a nephrostomy tube is necessary prior to connecting a manometer for renal pelvic pressure measurement.
`50545`	Pyelostomy or nephrostomy, tube or catheter placement, percutaneous; percutaneous placement of drainage catheter	Related when a new pyelostomy or nephrostomy tube is placed and subsequent pressure measurements are needed.
`51702`	Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual urine)	May be performed to evaluate bladder dynamics concurrently with renal pelvic pressure testing.
`99213`	Office or other outpatient visit, established patient, typically 15 minutes	Represents typical evaluation and management visit for pre- and post-procedure assessment when billed separately.

CPT 50390: Renal Cyst Aspiration with Sclerotherapy

CPT-50391-THERAPEUTIC-INSTILLATION-RENAL-PELVIS-URETER

CPT 50391: Therapeutic Instillation into Renal Pelvis or Ureter

CPT-50436-PERCUTANEOUS-NEPHROSTOMY-TRACT-DILATION

CPT 50436: Dilation of Percutaneous Nephrostomy Tract, With Possible Tube Placement

CPT-50437-PERCUTANEOUS-NEPHROSTOMY-TRACT-DILATION-AND-CREATION

CPT 50437: Percutaneous Nephrostomy Tract Dilation with New Tract Creation

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

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Billing Code Overview

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CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

Sign up for cpt 50396 policy alerts

Billing Code Overview

CPT 50396: Ureteral/Nephrostomy/Pyelostomy Pressure Measurement

Sign up for cpt 50396 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 50396 represent and where is it typically performed?

What procedure documentation elements are described for CPT 50396?

Which billing modifiers are relevant for CPT 50396 and are any modifier data missing?

What related CPT codes are frequently associated with pressure measurement using CPT 50396?

Which diagnoses are indicated as common clinical reasons to perform CPT 50396?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 50396 represent and where is it typically performed?

What procedure documentation elements are described for CPT 50396?

Which billing modifiers are relevant for CPT 50396 and are any modifier data missing?

What related CPT codes are frequently associated with pressure measurement using CPT 50396?

Which diagnoses are indicated as common clinical reasons to perform CPT 50396?

References