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CPT 50430: Percutaneous Ureterogram/Nephrostogram Diagnostic Study

CPT code 50430 represents a percutaneous diagnostic radiologic procedure in which a provider establishes a new access route and injects contrast into the ureter(s) or renal collecting system to perform a ureterogram or nephrostogram. Nationally, this code captures targeted imaging used to assess nephrostomy or pyelostomy tube function, identify ureteropelvic junction obstruction, and detect urine leakage—procedures that inform critical decisions about drainage, stent placement, and further intervention.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of the code, typical sites of service, and how the procedure is documented. The publication summarizes common billing modifiers encountered with this service and highlights typical denials and coverage considerations seen across major commercial payers and Medicare. It also outlines relevant coding relationships and service-line placement to aid billing and revenue-cycle teams.

This briefing is written for a national audience of clinicians, coding professionals, and policy analysts seeking a clear, operational understanding of CPT code 50430, its clinical purpose, and the payer environment that governs coverage and reimbursement.

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Billing Code Overview

CPT code 50430 describes a percutaneous contrast study of the urinary collecting system in which the provider creates a new access route and injects contrast into the ureter(s) (ureterogram) or kidney (nephrostogram) for diagnostic imaging. The procedure evaluates internal structures of the kidney, renal pelvis, and ureters and typically assesses nephrostomy or pyelostomy tube function, identifies ureteropelvic junction obstruction, or detects urine leakage around a tube insertion site.

Service type: Percutaneous diagnostic radiologic procedure with contrast injection (ureterogram/nephrostogram)

Typical site of service: Interventional radiology suite, hospital outpatient department, or ambulatory surgical center where percutaneous access and imaging guidance are available

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CPT 50430: Percutaneous Ureterogram/Nephrostogram Diagnostic Study

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Billing Code Overview

Service type: Percutaneous diagnostic radiologic procedure with contrast injection (ureterogram/nephrostogram)

Typical site of service: Interventional radiology suite, hospital outpatient department, or ambulatory surgical center where percutaneous access and imaging guidance are available

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with a long-standing indwelling percutaneous nephrostomy tube presents with decreased drainage and flank discomfort. The provider schedules a percutaneous nephrostogram/ureterogram to evaluate nephrostomy tube patency and to identify possible obstruction at the ureteropelvic junction or extravasation of urine around the tube tract. The procedure is performed in an interventional radiology suite under conscious sedation. After sterile preparation and local anesthesia at the existing tube site, the provider creates or accesses a percutaneous route and injects iodinated contrast into the renal collecting system under fluoroscopic guidance. Images are obtained to assess the renal pelvis, calyces, and ureter; any obstruction, filling defect, leak, or malposition of the tube is documented. The provider interprets the radiologic findings, provides procedural documentation including contrast volume and radiation exposure, and communicates results to the referring urologist. Typical workflow includes pre-procedure verification, IV access, sedation monitoring, imaging acquisition, post-procedure observation, and discharge instructions regarding tube care and signs of complication.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation component separate from technical services performed by the facility or radiology group.
`50`	Bilateral procedure	Use if bilateral percutaneous access and contrast studies are performed during the same session (rare for nephrostogram but applicable if both kidneys evaluated separately).
`51`	Multiple procedures	Use when additional distinct procedures are performed during the same session and payer requires modifier for multiple procedures.
`52`	Reduced services	Use when the procedure is partially reduced or not completed (e.g., contrast administration limited by patient instability).
`53`	Discontinued procedure	Use when the procedure is terminated due to unforeseen circumstances prior to completion.
`59`	Distinct procedural service	Use when this percutaneous nephrostogram/ureterogram is a distinct and separate procedure from other services performed on the same day.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons on the procedure.
`66`	Surgical team	Use when a surgical team approach is used (team reporting) for complex cases.
`73`	Discontinued outpatient hospital/ambulatory surgery before anesthesia administration	Use when the outpatient procedure is cancelled after patient prepared but before anesthesia started.
`74`	Discontinued outpatient hospital/ambulatory surgery after anesthesia administration	Use when the procedure is discontinued after anesthesia has begun.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use when the patient requires an unplanned repeat nephrostogram/ureterogram during the global period for a complication or unresolved issue.
`80`	Assistant surgeon	Use when a qualified assistant surgeon performs part of the procedure and payer recognizes assistant surgeon payment.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon is required and payer recognizes that modifier.
`TC`	Technical component	Use when billing only the technical component (facility resources, radiologic equipment, technologist) separate from the interpreting physician.
`QX`	Modifier for services performed by a certified registered nurse anesthetist (CRNA) with CRNA supervision documentation	Use when applicable anesthesia personnel billing rules require this modifier.

Taxonomy Code	Specialty	Notes
207RP0000X	Radiology	Interventional radiologists commonly perform percutaneous nephrostogram/ureterogram procedures.
2080P0222X	Urology	Urologists perform nephrostomy tube evaluations and may perform percutaneous access in select settings.
208K00000X	Diagnostic Radiology	Diagnostic radiologists with interventional privileges perform and interpret these fluoroscopic studies.
207L00000X	Vascular & Interventional Radiology	Vascular and interventional radiologists perform advanced percutaneous renal access and interventions.
363L00000X	Nephrology	Nephrologists may be involved in management of nephrostomy patients and ordering diagnostic imaging, though they rarely perform the procedure directly.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydronephrosis with ureteral stricture	Common indication to evaluate ureteral obstruction and nephrostomy function.
`N13.5`	Hydronephrosis and hydroureter caused by other obstruction	Used when imaging seeks the level and cause of urinary tract obstruction.
`N32.89`	Other specified disorders of bladder	Relevant when urine leakage or fistula is suspected and contrast study assesses for extravasation.
`N99.2`	Postprocedural ureteral stricture	Applied when evaluating suspected iatrogenic obstruction after prior urologic procedures.
`N28.9`	Disorder of kidney and ureter, unspecified	Used when more specific diagnosis is pending and diagnostic nephrostogram is performed.
`T83.098A`	Other mechanical complication of urinary (indwelling) device, initial encounter	Used when nephrostomy tube malfunction, leakage, or mechanical complication prompts imaging.
`R32`	Unspecified urinary incontinence	Used when imaging is performed to investigate potential leakage pathways contributing to incontinence.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50392`	Pyelostomy or antegrade nephrostomy, percutaneous, including imaging guidance when performed, exchange or manipulation of existing nephrostomy or pyelostomy tube without creating a new access tract	Performed when the session requires exchange or manipulation of an existing nephrostomy/pyelostomy tube rather than creation of a new percutaneous access; often performed in the same encounter if tube needs adjustment.
`50393`	Antegrade nephrostogram, radiological supervision and interpretation	Related diagnostic study; if performed separately from tube access, this code may be billed for radiologic nephrostogram without creation of a new catheter tract.
`36000`	Introduction of catheter, vein; simple infusion	May be billed for IV access placement required for sedation or contrast administration as a separate service when reportable.
`76775`	Ultrasound guidance for percutaneous needle placement (e.g., drainage, biopsy, or aspiration); first lesion	Ultrasound guidance may be used adjunctively for percutaneous renal access; billed when ultrasound guidance is performed in addition to fluoroscopy.
`74440`	Urography, antegrade or retrograde, pyelography only, radiological supervision and interpretation	Can be reported for antegrade pyelography/pyelogram imaging of the collecting system; relates to imaging component of evaluating urinary tract anatomy or obstruction.

CPT 50400: Pyeloplasty for Ureteropelvic Junction Obstruction

CPT-50405-PYELOPLASTY-URETEROPELVIC-JUNCTION-RECONSTRUCTION

CPT 50405: Pyeloplasty for Ureteropelvic Junction Obstruction

CPT-50431-NEPHROSTOGRAM-URETEROGRAM-CONTRAST-STUDY

CPT 50431: Nephrostogram or Ureterogram via Existing Access

CPT-50432-PERCUTANEOUS-NEPHROSTOMY-WITH-IMAGING-GUIDANCE

CPT 50432: Image-Guided Percutaneous Renal Pelvis Catheter Placement

CPT-50433-PERCUTANEOUS-NEPHROSTOMY-IMAGE-GUIDED-RENAL-DRAINAGE

CPT 50433: Image-Guided Percutaneous Nephrostomy

CPT-50434-PERCUTANEOUS-NEPHROSTOMY-TO-NEPHROURETERAL-CONVERSION

CPT 50434: Percutaneous Nephrostomy to Nephroureteral Catheter Conversion

CPT-50435-PERCUTANEOUS-NEPHROSTOMY-CATHETER-EXCHANGE-IMAGE-GUIDANCE

CPT 50435: Percutaneous Nephrostomy Catheter Exchange with Image Guidance

CPT-50500-KIDNEY-WOUND-SUTURE-REPAIR

CPT 50500: Suture Repair of Kidney Wound

CPT-50520-NEPHROCUTANEOUS-PYELOCUTANEOUS-FISTULA-CLOSURE

CPT 50520: Closure of Nephrocutaneous or Pyelocutaneous Fistula

CPT-50525-RENAL-FISTULA-CLOSURE-ABDOMINAL-APPROACH

CPT 50525: Renal Fistula Closure, Abdominal Approach

Showing 1–10 of 12

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	Use when billing only the physician interpretation component separate from technical services performed by the facility or radiology group.
`50`	Bilateral procedure	Use if bilateral percutaneous access and contrast studies are performed during the same session (rare for nephrostogram but applicable if both kidneys evaluated separately).
`51`	Multiple procedures	Use when additional distinct procedures are performed during the same session and payer requires modifier for multiple procedures.
`52`	Reduced services	Use when the procedure is partially reduced or not completed (e.g., contrast administration limited by patient instability).
`53`	Discontinued procedure	Use when the procedure is terminated due to unforeseen circumstances prior to completion.
`59`	Distinct procedural service	Use when this percutaneous nephrostogram/ureterogram is a distinct and separate procedure from other services performed on the same day.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons on the procedure.
`66`	Surgical team	Use when a surgical team approach is used (team reporting) for complex cases.
`73`	Discontinued outpatient hospital/ambulatory surgery before anesthesia administration	Use when the outpatient procedure is cancelled after patient prepared but before anesthesia started.
`74`	Discontinued outpatient hospital/ambulatory surgery after anesthesia administration	Use when the procedure is discontinued after anesthesia has begun.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use when the patient requires an unplanned repeat nephrostogram/ureterogram during the global period for a complication or unresolved issue.
`80`	Assistant surgeon	Use when a qualified assistant surgeon performs part of the procedure and payer recognizes assistant surgeon payment.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon is required and payer recognizes that modifier.
`TC`	Technical component	Use when billing only the technical component (facility resources, radiologic equipment, technologist) separate from the interpreting physician.
`QX`	Modifier for services performed by a certified registered nurse anesthetist (CRNA) with CRNA supervision documentation	Use when applicable anesthesia personnel billing rules require this modifier.

Taxonomy Code	Specialty	Notes
207RP0000X	Radiology	Interventional radiologists commonly perform percutaneous nephrostogram/ureterogram procedures.
2080P0222X	Urology	Urologists perform nephrostomy tube evaluations and may perform percutaneous access in select settings.
208K00000X	Diagnostic Radiology	Diagnostic radiologists with interventional privileges perform and interpret these fluoroscopic studies.
207L00000X	Vascular & Interventional Radiology	Vascular and interventional radiologists perform advanced percutaneous renal access and interventions.
363L00000X	Nephrology	Nephrologists may be involved in management of nephrostomy patients and ordering diagnostic imaging, though they rarely perform the procedure directly.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydronephrosis with ureteral stricture	Common indication to evaluate ureteral obstruction and nephrostomy function.
`N13.5`	Hydronephrosis and hydroureter caused by other obstruction	Used when imaging seeks the level and cause of urinary tract obstruction.
`N32.89`	Other specified disorders of bladder	Relevant when urine leakage or fistula is suspected and contrast study assesses for extravasation.
`N99.2`	Postprocedural ureteral stricture	Applied when evaluating suspected iatrogenic obstruction after prior urologic procedures.
`N28.9`	Disorder of kidney and ureter, unspecified	Used when more specific diagnosis is pending and diagnostic nephrostogram is performed.
`T83.098A`	Other mechanical complication of urinary (indwelling) device, initial encounter	Used when nephrostomy tube malfunction, leakage, or mechanical complication prompts imaging.
`R32`	Unspecified urinary incontinence	Used when imaging is performed to investigate potential leakage pathways contributing to incontinence.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50392`	Pyelostomy or antegrade nephrostomy, percutaneous, including imaging guidance when performed, exchange or manipulation of existing nephrostomy or pyelostomy tube without creating a new access tract	Performed when the session requires exchange or manipulation of an existing nephrostomy/pyelostomy tube rather than creation of a new percutaneous access; often performed in the same encounter if tube needs adjustment.
`50393`	Antegrade nephrostogram, radiological supervision and interpretation	Related diagnostic study; if performed separately from tube access, this code may be billed for radiologic nephrostogram without creation of a new catheter tract.
`36000`	Introduction of catheter, vein; simple infusion	May be billed for IV access placement required for sedation or contrast administration as a separate service when reportable.
`76775`	Ultrasound guidance for percutaneous needle placement (e.g., drainage, biopsy, or aspiration); first lesion	Ultrasound guidance may be used adjunctively for percutaneous renal access; billed when ultrasound guidance is performed in addition to fluoroscopy.
`74440`	Urography, antegrade or retrograde, pyelography only, radiological supervision and interpretation	Can be reported for antegrade pyelography/pyelogram imaging of the collecting system; relates to imaging component of evaluating urinary tract anatomy or obstruction.

CPT 50400: Pyeloplasty for Ureteropelvic Junction Obstruction

CPT-50405-PYELOPLASTY-URETEROPELVIC-JUNCTION-RECONSTRUCTION

CPT 50405: Pyeloplasty for Ureteropelvic Junction Obstruction

CPT-50431-NEPHROSTOGRAM-URETEROGRAM-CONTRAST-STUDY

CPT 50431: Nephrostogram or Ureterogram via Existing Access

CPT-50432-PERCUTANEOUS-NEPHROSTOMY-WITH-IMAGING-GUIDANCE

CPT 50432: Image-Guided Percutaneous Renal Pelvis Catheter Placement

CPT-50433-PERCUTANEOUS-NEPHROSTOMY-IMAGE-GUIDED-RENAL-DRAINAGE

CPT 50433: Image-Guided Percutaneous Nephrostomy

CPT-50434-PERCUTANEOUS-NEPHROSTOMY-TO-NEPHROURETERAL-CONVERSION

CPT 50434: Percutaneous Nephrostomy to Nephroureteral Catheter Conversion

CPT-50435-PERCUTANEOUS-NEPHROSTOMY-CATHETER-EXCHANGE-IMAGE-GUIDANCE

CPT 50435: Percutaneous Nephrostomy Catheter Exchange with Image Guidance

CPT-50500-KIDNEY-WOUND-SUTURE-REPAIR

CPT 50500: Suture Repair of Kidney Wound

CPT-50520-NEPHROCUTANEOUS-PYELOCUTANEOUS-FISTULA-CLOSURE

CPT 50520: Closure of Nephrocutaneous or Pyelocutaneous Fistula

CPT-50525-RENAL-FISTULA-CLOSURE-ABDOMINAL-APPROACH

CPT 50525: Renal Fistula Closure, Abdominal Approach

Showing 1–10 of 12

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.

OpenPayer

CPT 50430: Percutaneous Ureterogram/Nephrostogram Diagnostic Study

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Billing Code Overview

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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