CPT 50686 Ureteral Pressure Manometry Reimbursement | OpenPayer

Summary & Overview

CPT 50686: Ureteral Pressure Measurement via Catheter

CPT code 50686 denotes a diagnostic manometry procedure in which an indwelling ureteral catheter or existing ureterostomy tube is connected to a manometer to measure pressures or pressure differentials in the kidneys and ureters. Clinically, the procedure identifies obstruction, blockage, or abnormal dilatation of the urinary tract. Nationally, this code matters because it captures a targeted diagnostic intervention used by urologists and interventional radiologists to guide further management of upper urinary tract disorders.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical purpose and typical settings for the service, an overview of common billing modifiers collected with the code, and guidance on what information is and is not available in the input. The publication outlines expected use cases, typical sites of service such as hospital procedure suites and ambulatory surgical centers, and the clinical scenarios that commonly prompt measurement of ureteral pressures.

The report also highlights payer coverage considerations and benchmarking context where available. Data not provided in the input — including associated taxonomies, specific ICD-10 diagnosis pairings, related CPT codes, and payer-specific reimbursement rates — is noted as not available. This summary equips coding professionals, revenue staff, and clinicians with a concise national-level portrait of CPT code 50686 and its clinical role.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 50686ureteral manometryurology diagnosticsureteral catheter procedurerenal pressure measurementambulatory surgical centerhospital procedure

Billing Code Overview

CPT code 50686 describes a procedure in which a provider connects an indwelling ureteral catheter or an existing ureterostomy tube to a manometer to evaluate ureteral function and measure pressures or pressure differentials of fluids (gas or liquid) within the kidneys and ureters. The procedure is typically performed to assess obstruction, blockage, or dilatation of the urinary tract.

Service Type: Diagnostic pressure measurement of the ureter/kidney via indwelling catheter or ureterostomy tube

Typical Site of Service: Hospital-based settings, ambulatory surgical centers, or specialized urology procedure suites where access to manometry equipment and sterile catheter management is available.

Clinical & Coding Specifications

Clinical Context

A 58-year-old male with a history of nephrolithiasis and progressive left flank pain presents with decreased urine output from the left kidney and intermittent gross hematuria. Cross-sectional imaging (CT urogram) suggests hydronephrosis and a possible ureteral obstruction at the ureteropelvic junction. The urology team elects to evaluate intraluminal pressure and ureteral function by connecting the existing indwelling ureteral catheter to a manometer in the fluoroscopy suite. The procedure is performed with the patient in the supine position under conscious sedation. After sterile preparation, the indwelling ureteral catheter is accessed, connected to a calibrated manometer, and pressures are recorded at rest and during provocation (e.g., gentle irrigation or bladder filling) to assess for variability consistent with obstruction or impaired drainage. Measurements inform decisions about need for stent placement, surgical repair, or continued conservative management. Typical documentation includes indication, catheter type and size, manometer readings, patient tolerance, and any immediate complications.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician’s professional component separate from technical services for measurement interpretation.
`50`

CPT 50694: Image-Guided Ureteral Stent Placement

CPT-50690-CONTRAST-EVALUATION-ILEAL-CONDUIT-URETER-RENAL-PELVIS

CPT 50690: Contrast Evaluation of Ileal Conduit, Ureter, Renal Pelvis

CPT-50688-URETEROSTOMY-TUBE-OR-URETERAL-STENT-EXCHANGE-VIA-ILEAL-CONDUIT

CPT 50688: Ureterostomy Tube or Ureteral Stent Exchange via Ileal Conduit

CPT-50684-URETEROSTOMY-CONTRAST-EVALUATION-URETER-RENAL-PELVIS

CPT 50684: Contrast Study of Ureterostomy Tube and Renal Pelvis

CPT-50693-NEPHROSTOMY-TRACT-URETERAL-STENT-PLACEMENT

CPT 50693: Ureteral Stent Placement via Nephrostomy Tract

CPT-50695-PERCUTANEOUS-NEPHROSTOMY-NEPHROSTOMY-CATHETER-URETERAL-STENT

CPT 50695: Image-Guided Percutaneous Nephrostomy with Nephrostomy Catheter and Ureteral Stent

Taxonomy Code	Specialty	Notes
`2080S0105X`	Urology	Specialists who most commonly perform ureteral manometry and related procedures.
`208800000X`	General Surgery	Surgeons who may perform urinary tract procedures in select centers.
`363L00000X`	Radiology — Diagnostic	Interventional radiologists may perform pressure measurements when accessing nephrostomy or ureteral catheters under imaging guidance.
`367A00000X`	Anesthesiology	Anesthesia providers involved in sedation or general anesthesia during the procedure.
`163WL0500X`	Physician Assistant	Advanced practice providers who may assist or perform the procedure per state scope and facility policy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydronephrosis with ureteral stricture	Common indication when ureteral pressure measurement is needed to assess obstruction severity.
`N13.8`	Other obstructive and reflux uropathy	Used for obstructive processes requiring functional assessment of ureteral drainage.
`N20.0`	Calculus of kidney	Nephrolithiasis can cause hydronephrosis and necessitate manometric evaluation when obstruction is suspected.
`N13.6`	Pyonephrosis	Infection with obstruction where pressure monitoring can guide drainage and intervention.
`N28.9`	Disorder of kidney and ureter, unspecified	Used when specific diagnosis is pending but functional assessment is required.
`R39.15`	Urgency of urination	Symptom code that may accompany obstructive uropathy prompting further evaluation including manometry.
`N11.9`	Chronic tubulo-interstitial nephritis, unspecified	Chronic upper tract pathology that may impair drainage and warrant functional testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50680`	Pyelostomy, insertion of a catheter, temporary or indwelling, percutaneous or open	May precede manometry when an indwelling nephrostomy or pyelostomy catheter is placed to drain and later measure pressures.
`52000`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	May be performed before or after manometric testing to evaluate lower urinary tract anatomy or to place/verify ureteral catheters.
`52332`	Cystourethroscopy, with insertion of ureteral stent, with or without contrast or radiologic monitoring; simple (eg, single)	Performed when manometry indicates obstruction and ureteral stenting is chosen as the therapeutic response.
`50390`	Insertion, removal, or replacement of ureteral catheter via existing nephrostomy tract (percutaneous)	May be performed when access for manometry is via a nephrostomy tract and catheter manipulation is required.
`51701`	Single-channel closed drainage catheter, simple (eg, Foley)	May be used concurrently for bladder drainage during pressure measurements or provocation testing.
`76942`	Ultrasonic guidance for vascular access and/or for needle guidance (eg, ultrasound)	May be used if ultrasound guidance is needed for percutaneous access to the collecting system prior to manometry.

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