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CPT 51050: Open Bladder Stone Extraction

CPT code 51050 denotes an open surgical incision into the urinary bladder to remove a bladder calculus without resection of the bladder neck. This code captures a definitive, operative approach to bladder stone removal when less invasive methods (transurethral extraction or lithotripsy) are not appropriate or feasible. Nationally, accurate use of 51050 matters for appropriate facility and professional reimbursement, procedure tracking, and quality reporting for urologic surgical care. Key payers discussed include Aetna, Blue Cross Blue Shield (BCBS), Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common payer coverage considerations, and a summary of typical sites of service. The publication outlines benchmarks and reimbursement themes where available, highlights documentation elements tied to the CPT description, and summarizes policy considerations that affect coding and claims processing. Data not available in the input will be noted where applicable; the content focuses on the code definition, clinical setting, and the principal payer landscape at a national level.

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Billing Code Overview

CPT code 51050 describes a surgical procedure in which the provider makes an incision in the urinary bladder to remove a calculus (bladder stone) without performing resection of the bladder neck. This is an open surgical bladder stone extraction rather than an endoscopic or lithotripsy approach.

Service type: Surgical procedure — open bladder stone removal (cystotomy with stone extraction)
Typical site of service: Inpatient or outpatient surgical setting such as an operating room in a hospital or an ambulatory surgery center, depending on clinical indications and patient status.

Data not available in the input.

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CPT 51050: Open Bladder Stone Extraction

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Billing Code Overview

Service type: Surgical procedure — open bladder stone removal (cystotomy with stone extraction)
Typical site of service: Inpatient or outpatient surgical setting such as an operating room in a hospital or an ambulatory surgery center, depending on clinical indications and patient status.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents with lower abdominal pain, urinary frequency, and intermittent gross hematuria. Imaging (KUB radiograph and non-contrast CT) demonstrates a 2.5 cm radiopaque calculus within the urinary bladder causing recurrent urinary tract infections and obstructive voiding symptoms. Conservative removal attempts with transurethral extraction under cystoscopic guidance were unsuccessful due to the stone's size and embedded position. The urologist schedules an open cystolithotomy for direct access to the bladder and stone removal. The clinical workflow includes preoperative evaluation (history, physical, urinalysis, urine culture with targeted antibiotics if infected), informed consent discussing risks (bleeding, infection, injury to adjacent structures), preoperative anesthesia evaluation and site verification, operative incision and cystotomy, stone extraction without bladder neck resection, bladder closure with layers and drain as indicated, postoperative monitoring for hematuria and urinary retention, pain control, and follow-up for wound and bladder healing. Typical perioperative documentation includes indication, imaging reports, operative note describing incision into the bladder and stone removal, estimated blood loss, specimen disposition, and postoperative instructions for urinary catheter management and activity restrictions.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier reported / not commonly used clinically	Rarely appended; included in raw list but not typically applied to outpatient procedural billing
`11`	Office or other outpatient visit by the same physician	Append when the same provider performs the global service and documents a significant, separately identifiable evaluation and management service on the same day in accordance with payer rules
`22`	Increased procedural services	Use when the cystolithotomy required substantially greater effort, time, or complexity than typical and documentation supports increased work
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for an otherwise normally local/monitored procedure and anesthesia is unusual for the setting
`26`	Professional component	Use when billing only the physician’s professional component separate from the technical component for diagnostic services (rare for open cystolithotomy)
`50`	Bilateral procedure	Not generally applicable to bladder stone removal; included if an unusual bilateral anatomic approach or bilateral procedures coded separately are performed
`51`	Multiple procedures	Use when additional unrelated procedures are performed at the same operative session and payer requires modifier to indicate multiple procedures
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned and documentation supports the reduction
`53`	Discontinued procedure	Use when the cystolithotomy is started but discontinued due to extenuating circumstances (e.g., unstable patient) with appropriate documentation
`59`	Distinct procedural service	Use when another procedure performed during the same session is distinct and separate from the cystolithotomy (e.g., concurrent unrelated genitourinary procedure)
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure and documentation supports shared performance
`63`	Procedure performed on infants less than 4 kg	Use if patient is an infant under weight threshold and documentation supports modifier requirement
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure within the global period for a separate documented reason (not in raw list; not included)
`78`	Unplanned return to operating room by same physician following initial procedure for a related procedure during the global period	Use when the patient returns to the OR for a related complication (e.g., postoperative bleeding requiring re-exploration)
`80`	Assistant surgeon	Use when an assistant surgeon (not a co-surgeon) assists and payer requires modifier to identify assistant involvement

Taxonomy Code	Specialty	Notes
208800000X	Urology	Primary specialty performing cystolithotomy procedures
207L00000X	General Surgery	May perform open bladder procedures in some settings or trauma cases
2086S0106X	Pediatric Urology	Performs bladder stone removal in pediatric patients when applicable
2080P0206X	Surgery - Urologic	Alternate taxonomy for urologic surgeons in some payer files
207XS0102X	Trauma Surgery	In acute trauma with bladder injury and concomitant stone management, trauma surgeons may be involved

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N21.0`	Calculus of bladder with hematuria	Direct indication for bladder stone removal when associated with bleeding
`N21.1`	Calculus of bladder without hematuria	Primary diagnosis for symptomatic bladder stones causing voiding symptoms or infection
`N39.0`	Urinary tract infection, site not specified	Recurrent or persistent infections may be an indication for definitive stone removal
`N32.0`	Bladder-neck obstruction	Anatomic obstruction contributing to stone formation or retention; may influence surgical approach but bladder neck not resected in this procedure
`N28.1`	Chronic kidney disease, stage unspecified (placeholder for renal insufficiency)	Renal dysfunction influences perioperative management and fluid/antibiotic decisions; include appropriate specific CKD code in documentation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51040`	Cystolithotomy, including drainage of diverticulum (separate procedure)	Alternative or related open bladder stone procedure; may be coded when diverticulum drainage is performed with stone removal
`52310`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	Often performed preoperatively or intraoperatively for diagnostic visualization prior to deciding open cystolithotomy
`52320`	Cystourethroscopy, diagnostic, with removal of foreign body or calculus by forceps	Performed when transurethral cystoscopic stone extraction is attempted and may precede conversion to open cystolithotomy if unsuccessful
`50590`	Extracorporeal shock wave lithotripsy (ESWL), renal and ureteral stones	Alternative, less invasive treatment for urinary calculi when anatomy and stone characteristics permit; may be considered before open surgery
`51990`	Insertion of temporary bladder catheter (eg, Foley)	Performed preoperatively or postoperatively for bladder drainage and bladder irrigation after cystolithotomy
`11010`	Debridement of skin/soft tissue for wound management (minor)	May be used if the operative incision requires additional soft tissue management or debridement at the same session

CPT 51020: Bladder Cystotomy/Cystostomy with Fulguration or Intravesical Therapy

CPT-51040-CYSTOSTOMY-CYSTOTOMY-DRAINAGE

CPT 51040: Cystostomy/Cystotomy with Drainage

CPT-51045-URETERAL-STENT-PLACEMENT-VIA-CYSTOTOMY

CPT 51045: Ureteral Stent/Catheter Placement via Cystotomy

CPT-51060-URETERAL-STONE-REMOVAL-WITH-BLADDER-NECK-RESECTION

CPT 51060: Ureteral Stone Removal with Bladder Neck Resection

CPT-51065-URETERAL-STONE-REMOVAL-VIA-CYSTOTOMY

CPT 51065: Bladder Incision and Ureteral Stone Removal

CPT-51080-PERIVESICAL-ABSCESS-INCISION-AND-DRAINAGE

CPT 51080: Incision and Drainage of Perivesical Abscess

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier reported / not commonly used clinically	Rarely appended; included in raw list but not typically applied to outpatient procedural billing
`11`	Office or other outpatient visit by the same physician	Append when the same provider performs the global service and documents a significant, separately identifiable evaluation and management service on the same day in accordance with payer rules
`22`	Increased procedural services	Use when the cystolithotomy required substantially greater effort, time, or complexity than typical and documentation supports increased work
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for an otherwise normally local/monitored procedure and anesthesia is unusual for the setting
`26`	Professional component	Use when billing only the physician’s professional component separate from the technical component for diagnostic services (rare for open cystolithotomy)
`50`	Bilateral procedure	Not generally applicable to bladder stone removal; included if an unusual bilateral anatomic approach or bilateral procedures coded separately are performed
`51`	Multiple procedures	Use when additional unrelated procedures are performed at the same operative session and payer requires modifier to indicate multiple procedures
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned and documentation supports the reduction
`53`	Discontinued procedure	Use when the cystolithotomy is started but discontinued due to extenuating circumstances (e.g., unstable patient) with appropriate documentation
`59`	Distinct procedural service	Use when another procedure performed during the same session is distinct and separate from the cystolithotomy (e.g., concurrent unrelated genitourinary procedure)
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure and documentation supports shared performance
`63`	Procedure performed on infants less than 4 kg	Use if patient is an infant under weight threshold and documentation supports modifier requirement
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure within the global period for a separate documented reason (not in raw list; not included)
`78`	Unplanned return to operating room by same physician following initial procedure for a related procedure during the global period	Use when the patient returns to the OR for a related complication (e.g., postoperative bleeding requiring re-exploration)
`80`	Assistant surgeon	Use when an assistant surgeon (not a co-surgeon) assists and payer requires modifier to identify assistant involvement

Taxonomy Code	Specialty	Notes
208800000X	Urology	Primary specialty performing cystolithotomy procedures
207L00000X	General Surgery	May perform open bladder procedures in some settings or trauma cases
2086S0106X	Pediatric Urology	Performs bladder stone removal in pediatric patients when applicable
2080P0206X	Surgery - Urologic	Alternate taxonomy for urologic surgeons in some payer files
207XS0102X	Trauma Surgery	In acute trauma with bladder injury and concomitant stone management, trauma surgeons may be involved

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N21.0`	Calculus of bladder with hematuria	Direct indication for bladder stone removal when associated with bleeding
`N21.1`	Calculus of bladder without hematuria	Primary diagnosis for symptomatic bladder stones causing voiding symptoms or infection
`N39.0`	Urinary tract infection, site not specified	Recurrent or persistent infections may be an indication for definitive stone removal
`N32.0`	Bladder-neck obstruction	Anatomic obstruction contributing to stone formation or retention; may influence surgical approach but bladder neck not resected in this procedure
`N28.1`	Chronic kidney disease, stage unspecified (placeholder for renal insufficiency)	Renal dysfunction influences perioperative management and fluid/antibiotic decisions; include appropriate specific CKD code in documentation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51040`	Cystolithotomy, including drainage of diverticulum (separate procedure)	Alternative or related open bladder stone procedure; may be coded when diverticulum drainage is performed with stone removal
`52310`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	Often performed preoperatively or intraoperatively for diagnostic visualization prior to deciding open cystolithotomy
`52320`	Cystourethroscopy, diagnostic, with removal of foreign body or calculus by forceps	Performed when transurethral cystoscopic stone extraction is attempted and may precede conversion to open cystolithotomy if unsuccessful
`50590`	Extracorporeal shock wave lithotripsy (ESWL), renal and ureteral stones	Alternative, less invasive treatment for urinary calculi when anatomy and stone characteristics permit; may be considered before open surgery
`51990`	Insertion of temporary bladder catheter (eg, Foley)	Performed preoperatively or postoperatively for bladder drainage and bladder irrigation after cystolithotomy
`11010`	Debridement of skin/soft tissue for wound management (minor)	May be used if the operative incision requires additional soft tissue management or debridement at the same session

CPT 51020: Bladder Cystotomy/Cystostomy with Fulguration or Intravesical Therapy

CPT-51040-CYSTOSTOMY-CYSTOTOMY-DRAINAGE

CPT 51040: Cystostomy/Cystotomy with Drainage

CPT-51045-URETERAL-STENT-PLACEMENT-VIA-CYSTOTOMY

CPT 51045: Ureteral Stent/Catheter Placement via Cystotomy

CPT-51060-URETERAL-STONE-REMOVAL-WITH-BLADDER-NECK-RESECTION

CPT 51060: Ureteral Stone Removal with Bladder Neck Resection

CPT-51065-URETERAL-STONE-REMOVAL-VIA-CYSTOTOMY

CPT 51065: Bladder Incision and Ureteral Stone Removal

CPT-51080-PERIVESICAL-ABSCESS-INCISION-AND-DRAINAGE

CPT 51080: Incision and Drainage of Perivesical Abscess

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 51050: Open Bladder Stone Extraction

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Billing Code Overview

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CPT 51050: Open Bladder Stone Extraction

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References