Summary & Overview
CPT 50694: Image-Guided Ureteral Stent Placement
CPT code 50694 represents image-guided creation of an access route into the ureter with placement of a ureteral stent at a site of stricture, using ultrasound and/or fluoroscopy and, when performed, contrast injection for nephrostogram or ureterogram. This procedure is clinically important for maintaining urinary drainage and preventing obstruction in patients with ureteral narrowing. Nationally, 50694 affects care pathways in urology and interventional radiology and has implications for facility resource use, imaging capabilities, and procedural coding consistency.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for the code, the typical sites of service where it is performed, and which payers commonly adjudicate claims for this service. The publication summarizes billing and coding considerations, common modifiers used with image-guided procedures, and what to expect in terms of code bundling and radiology supervision/interpretation documentation. It also highlights benchmarks and policy updates relevant to image-guided urologic interventions, while providing operational context for coding teams and revenue cycle stakeholders. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 50694 describes an image-guided procedure to create an access route into the ureter and place a ureteral stent at an area of stricture to prevent obstruction or maintain urine drainage. The provider uses ultrasound and/or fluoroscopy to visualize live images and guide stent placement. The procedure may include injection of contrast material to perform a nephrostogram (imaging of internal kidney structures) and a ureterogram (imaging of the ureter). The description specifies that the provider does not place a separate nephrostomy catheter.
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Service type: Image-guided ureteral stent placement with contrast imaging as indicated
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or interventional radiology suite where fluoroscopy and ultrasound are available
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of recurrent nephrolithiasis and progressive left-sided hydronephrosis presents with flank pain, rising creatinine, and imaging evidence of proximal ureteral stricture causing obstruction. The urology team determines that retrograde stent placement via cystoscopy is unsuccessful due to an impassable stricture. The interventional radiology or urology proceduralist performs image-guided ureteral stent placement using real-time ultrasound and fluoroscopy to access the ureter, traverse the stricture, and deploy a ureteral stent to re-establish drainage. Contrast may be injected for a nephrostogram or ureterogram to define anatomy and confirm stent position. The procedure is performed in a hospital interventional suite, operating room, or ambulatory surgery center under conscious sedation or general anesthesia as indicated. Radiological supervision and interpretation are included in the service, and no separate nephrostomy catheter is left in place as part of this service.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separately for the physician's interpretation of imaging when technical component billed by facility or another entity |
52 |