Summary & Overview
CPT 50940: Ureteral Constricting Device Removal
CPT code 50940 denotes a surgical procedure to remove a constricting device from the ureter, such as a thread, wire, or band placed during prior surgery or retained accidentally. The code captures operative management aimed at relieving ureteral obstruction and restoring urinary flow—an important intervention to prevent renal compromise, infection, and ongoing morbidity. Nationally, this code matters because it is used in acute urologic settings where timely operative intervention affects patient outcomes and downstream resource use.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, benchmarks where available, common modifier usage, and implications for claims processing. The publication summarizes coding intent, typical care settings (hospital operating room and ambulatory surgical center), and payer considerations relevant to coverage and billing workflows.
The report provides: a clear description of clinical indications and the procedure; guidance on where this service is commonly provided; expected payer coverage landscape; and notes on common modifiers and administrative factors that affect claim adjudication. Data not available in the input is identified explicitly.
Billing Code Overview
CPT code 50940 describes a surgical procedure to remove a constricting device from the ureter, such as a thread, wire, or constricting band placed during prior surgery to manage urinary incontinence or retained accidentally. The procedure typically involves operative exploration of the ureter to locate and extract the constricting material, relieving obstruction and restoring urine flow.
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Service type: Surgical removal/exploratory ureteral procedure
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Typical site of service: Hospital operating room or ambulatory surgical center where urologic procedures are performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old female with prior anti-incontinence sling surgery presents with flank pain, decreased urine output on the affected side, and hydronephrosis on ultrasound. Imaging suggests a constricting surgical band or suture entrapping the ureter causing partial obstruction. The urology team evaluates the patient in clinic, obtains CT urogram to define level of obstruction, and schedules a planned operative removal of the constricting device. In the operating room or ambulatory surgery center, under general anesthesia, the surgeon exposes the ureter laparoscopically or via open incision, identifies the constricting thread/wire/band, and removes or releases it to restore ureteral patency. Intraoperative ureteral stent placement may be performed to protect the ureter post-release. Postoperatively the patient is monitored for urine output, signs of leak or infection, and discharged with follow-up for stent removal if placed. Typical site of service is an operating room in a hospital or ambulatory surgery center. Service type is a surgical corrective procedure to remove an implanted or retained constricting device on the ureter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default / No modifier required by payer | Rarely used; include when no specific modifier applies and payer requires a default code |
11 |