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    v1.0.30
    OpenPayerBilling CodesIncision/Biopsy Procedures on the UreterCPT cpt-50610-open-ureteral-stone-removal-upper-ureter
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    CPT 50610: Upper Ureterotomy for Stone Removal

    Medicare pays $861 on average nationally for this procedure.

    CPT code 50610 describes an open surgical procedure involving an incision into the upper one third of the ureter to remove a ureteral stone; this is a ureterotomy for stone extraction typically classified as a surgical urology procedure and is performed in an operating room or other facility-based surgical setting under appropriate anesthesia.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 45–70 year old adult presenting with acute flank pain, gross hematuria, or recurrent ureteral colic. Imaging (non-contrast CT abdomen/pelvis or renal ultrasound) demonstrates a radiopaque calculus lodged in the proximal third of the ureter. Initial conservative management (hydration, analgesia, medical expulsive therapy) has failed or the stone is unlikely to pass because of size (>6–7 mm), persistent obstruction with hydronephrosis, infection risk, or intractable pain. The urologist schedules a surgical ureterotomy of the proximal ureter under general anesthesia.

    Preoperative workflow includes history and physical, basic labs (CBC, BMP, urinalysis, urine culture), cross-sectional imaging review, consent for ureteral surgery and possible stent placement, and anesthesia evaluation. Intraoperative steps typically include cystoscopic evaluation, placement of ureteral catheter or guidewire, open or limited incision into the upper one-third of the ureter (ureterotomy) with stone extraction, inspection of the ureteral lumen, possible placement of a ureteral stent, and layered closure or omental wrap as indicated. Postoperative care includes pain control, monitoring for urinary leak or infection, stent management and a short inpatient stay or same-day discharge depending on clinical status.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    52000Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washingPreoperative cystoscopic evaluation of the bladder and distal ureteral orifice; may be used to place ureteral catheter/guidewire.
    52332Cystoureteroscopy, with lithotripsy (ureteral)Endoscopic alternative for ureteral stones; may be performed instead of open ureterotomy when feasible.
    52352Cystoureteroscopy, with removal of ureteral calculus (with or without use of basket)Endoscopic stone extraction alternative to open ureterotomy; may occur before deciding on ureterotomy.
    50720Ureteroplasty, segmental resection with uretero-ureterostomy or reimplantationPerformed when ureteral injury or stricture requires reconstruction after stone removal.
    52005Cystourethroscopy with insertion of indwelling ureteral stent (eg, Gibbons)Placement of ureteral stent intraoperatively or postoperatively to ensure drainage following ureterotomy.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    2080P0206X
    207K00000X
    208VP0000X
    246Z00000X
    173C00000X
    208D00000X
    261QR0200X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E87.1Hypo-osmolality and hyponatremia
    E87.6Hypokalemia
    I12.9Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
    I13.10Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
    N11.0Nonobstructive reflux-associated chronic pyelonephritis
    N13.2Hydronephrosis with renal and ureteral calculous obstruction
    N13.6Pyonephrosis
    N17.9Acute kidney failure, unspecified
    N20.0Calculus of kidney
    N20.1Calculus of ureter

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

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

    CPT 50600: Ureterotomy with Ureteral Drainage Catheter Placement

    CPT-50605-URETERAL-STENT-PLACEMENT-VIA-URETEROTOMY

    CPT 50605: Ureteral Stent Placement via Ureterotomy

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

    CPT 50606: Endoluminal Biopsy of Ureter and Renal Pelvis

    CPT-50620-OPEN-URETEROTOMY-STONE-REMOVAL-MID-URETER

    CPT 50620: Ureterotomy, Middle Third, Stone Removal

    CPT-50630-DISTAL-URETEROTOMY-STONE-EXTRACTION

    CPT 50630: Incision of Lower Ureter for Stone Removal

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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