Summary & Overview
CPT 50695: Image-Guided Percutaneous Nephrostomy with Nephrostomy Catheter and Ureteral Stent
CPT code 50695 represents image‑guided percutaneous nephrostomy with placement of a nephrostomy catheter and ureteral stent, including radiological supervision and interpretation. This procedure relieves urinary obstruction, manages strictures, and maintains renal drainage when antegrade access is required. It is commonly performed by interventional radiologists using ultrasound and/or fluoroscopy, often combined with contrast imaging of the renal collecting system.
Nationally, CPT code 50695 is important for hospitals and ambulatory surgical centers that provide interventional urinary drainage services. Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise reference for clinicians, billing staff, and revenue cycle teams about the clinical context, typical sites of service, and payer coverage considerations for the code.
Readers will learn the clinical intent of the service, the settings where it is typically performed, common procedural elements included in the code (image guidance, catheter and stent placement, and possible contrast studies), and which major payers are relevant for coverage considerations. Data not available in the input is indicated where applicable, and the content focuses on national applicability without state‑specific guidance.
Billing Code Overview
CPT code 50695 describes a percutaneous nephrostomy with placement of a nephrostomy catheter and a ureteral stent performed under image guidance. The provider uses ultrasound and/or fluoroscopy to create a percutaneous access route into the kidney, guide catheter and stent placement, and may inject contrast to perform a nephrostogram or ureterogram. The procedure includes radiological supervision and interpretation.
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Service type: Image‑guided percutaneous renal drainage with nephrostomy catheter and ureteral stent placement
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or interventional radiology suite where fluoroscopy and ultrasound are available
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of recurrent ureteral stricture following prior stone disease presents with flank pain, fever, and rising creatinine. Imaging (CT abdomen/pelvis) demonstrates hydronephrosis of the left kidney with suspected obstructing ureteral narrowing. The interventional radiology team schedules a percutaneous nephrostomy with antegrade ureteral stent placement under ultrasound and fluoroscopic guidance to decompress the collecting system, obtain cultures, and restore urinary drainage.
The clinical workflow includes pre-procedure evaluation (consent, coagulation assessment, imaging review), procedural sedation or monitored anesthesia care, percutaneous renal access using real-time ultrasound and/or fluoroscopy, placement of a nephrostomy catheter and antegrade ureteral stent, optional injection of contrast for nephrostogram/ureterogram to confirm position and assess the stricture, and post-procedure imaging and care. Radiological supervision and interpretation are included in the service. Hospital inpatient or outpatient interventional radiology suite are typical sites of service depending on acuity and anesthesia needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation component separate from technical component |