CPT 50605 Ureteral Stent Placement Reimbursement | OpenPayer

Summary & Overview

CPT 50605: Ureteral Stent Placement via Ureterotomy

CPT code 50605 denotes surgical placement of a ureteral stent through an incision in the ureter (ureterotomy) to establish or maintain urinary drainage. This code captures a specific surgical approach distinct from percutaneous or purely endoscopic stent placements, and it is relevant to hospitals and surgical practices managing obstructive uropathy, ureteral injury repair, and other urologic conditions requiring internal drainage.

Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for use of the code, typical sites of service, and common billing modifiers associated with surgical procedures. The publication summarizes typical billing considerations, common payer coverage patterns, and coding relationships that affect claims processing for ureteral stent placement via ureterotomy.

This resource is intended for revenue cycle, coding professionals, and clinical leaders seeking a concise reference on CPT code 50605, including clinical indications, where the procedure is performed, and the types of information payers generally require for authorization and claim adjudication. Data not available in the input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare50605CPTureteral stentureterotomyurologysurgical procedureoperating roomendourology

Billing Code Overview

CPT code 50605 describes a surgical procedure in which the provider places any type of stent into the ureter by making an incision into the ureter. The procedure involves direct access to the ureteral lumen to position a stent for drainage or support.

Service type: Open or direct surgical ureteral stent placement (surgical endourology procedure)
Typical site of service: Operating room or procedure suite in an inpatient or outpatient surgical setting

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–75 year-old adult presenting with obstructive ureteral pathology such as ureteral stricture, iatrogenic ureteral injury, or ureteral obstruction from stones or extrinsic compression. The patient may have flank pain, hydronephrosis on imaging (renal ultrasound or CT urogram), and impaired renal drainage with or without infection. The urologist schedules an open or laparoscopic ureterotomy to place a ureteral stent directly through an incision in the ureter when retrograde cystoscopic stent placement is not feasible or when concurrent repair of a stricture or injury is required. The procedure is performed in an operating room or designated procedural suite under general or regional anesthesia. Intraoperative workflow typically includes preoperative antibiotics, cystoscopic evaluation as needed, intraoperative imaging (fluoroscopy), identification of the ureteral segment, longitudinal ureterotomy, placement of a temporary internal ureteral stent (double-J or single pigtail), possible ureteral repair or reconstruction, and layered closure. Postoperative care includes monitoring for hematuria, urinary output, signs of infection, and scheduling stent removal or exchange in 4–12 weeks depending on the indication. Common clinical teams include urology surgeons, anesthesiology, perioperative nursing, and radiology support for fluoroscopy.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician interpretation portion when imaging/diagnostic component is separately billed.

CPT 50620: Open Ureterotomy for Mid‑Ureter Stone Removal

CPT-50600-URETERAL-INCISION-AND-EXTERNAL-DRAINAGE

CPT 50600: Ureteral Incision and External Drainage

CPT-50630-DISTAL-URETEROTOMY-STONE-EXTRACTION

CPT 50630: Distal Ureterotomy for Stone Extraction

CPT-50606-PERCUTANEOUS-ENDOLUMINAL-URETER-RENAL-PELVIS-BIOPSY

CPT 50606: Percutaneous Endoluminal Ureter and Renal Pelvis Biopsy

CPT-50610-OPEN-URETERAL-STONE-REMOVAL-UPPER-URETER

CPT 50610: Open Removal of Stone from Upper Ureter

Taxonomy Code	Specialty	Notes
`2080S00000X`	Urology	Primary specialty performing ureterotomy with stent placement.
`2080P0207X`	Pediatric Urology	Performs procedure in pediatric patients and congenital ureteral conditions.
`207P00000X`	General Surgery	May perform when combined abdominal procedures require ureteral repair during open surgery.
`2084P0800X`	Female Pelvic Medicine & Reconstructive Surgery	Involved when ureteral injury occurs during pelvic reconstructive procedures.
`207L00000X`	Colon & Rectal Surgery	Occasionally involved during colorectal operations with ureteral involvement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydronephrosis with ureteral stricture	Common indication for ureteral incision and stent placement to relieve obstruction and preserve renal function.
`S37.5XXA`	Injury of ureter, initial encounter	Iatrogenic or traumatic ureteral injuries requiring incision and stenting as part of repair and drainage.
`N20.0`	Calculus of kidney	Kidney stone disease with obstruction extending into ureter may require stent placement when definitive stone management is delayed.
`N20.1`	Calculus of ureter	Ureteral stones causing obstruction or infection that necessitate stent placement if retrograde removal is not possible.
`N13.7`	Hydronephrosis with ureteropelvic obstruction	Congenital or acquired obstruction at the ureteropelvic junction managed with stent placement during surgical correction.
`N28.89`	Other specified disorders of kidney and ureter	Miscellaneous pathologies leading to obstruction or injury where stent placement is indicated.
`N10`	Acute tubulo-interstitial nephritis	When complicated by obstruction and flank pain, temporary stenting may be part of management (less common but relevant).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52287`	Cystoureteroscopy, with removal of ureteral calculus; complicated (includes ureteral stent placement when performed via cystoscope)	Performed prior to or instead of open ureteral stent placement when retrograde access is possible; may be used for stone management with stent placement.
`50590`	Lithotripsy, percutaneous, renal and/or ureteral; with or without nephrostomy or pyelotomy	Antegrade approaches for stone disease that may include nephrostomy and subsequent ureteral stent placement via percutaneous tract.
`50260`	Nephroureterectomy, complete	Performed in extensive disease where ureteral stent placement might be part of preoperative drainage or intraoperative management.
`50705`	Repair of ureter, ureterorrhaphy, with or without stent	Performed when ureteral repair is needed in conjunction with stent placement; often billed when primary repair is performed.
`55700`	Repair, ureteral reimplantation (ureteroneocystostomy)	Performed when distal ureteral reconstruction is required and a stent is placed to splint the repair.
`74440`	Fluoroscopy, kidney, ureter and bladder (KUB) and/or contrast studies	Intraoperative or postoperative imaging to confirm stent position; often reported when separate imaging is medically necessary.

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