Summary & Overview
CPT 51060: Ureteral Stone Removal with Bladder Neck Resection
CPT code 51060 represents an open urologic operation combining ureteral stone removal via incision into the bladder and ureter with simultaneous resection of the bladder neck. It denotes a more invasive operative approach than endoscopic stone extraction and is relevant where stone burden, anatomy, or concomitant bladder outlet pathology necessitate an open procedure. Nationally, this code captures complex urologic operative care that can affect surgical resource use, hospital length of stay, and facility reimbursement patterns.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, plus guidance on where this code fits in surgical coding portfolios. The publication outlines common modifiers and payer considerations where available and highlights implications for billing and claims processing in higher-acuity urologic procedures.
This summary prepares clinicians, coders, and policy analysts to understand the clinical meaning of the code, typical sites of service, and the payer landscape covered in the accompanying detailed sections. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 51060 describes an open surgical procedure in which the surgeon makes an incision in the urinary bladder and ureter to remove a ureteral stone and performs resection of the bladder neck as part of the same operative session. This combines ureterolithotomy (stone removal via incision into the ureter/bladder) with concurrent bladder neck resection.
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Service type: Open urologic surgery involving ureter and bladder neck resection
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Typical site of service: Inpatient operating room or ambulatory surgical center depending on clinical severity and institutional practice
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of recurrent nephrolithiasis and lower urinary tract symptoms presents with acute flank pain and radiographic evidence of a large distal ureteral stone lodged at the ureterovesical junction with significant hydronephrosis. Conservative measures and ureteroscopic extraction are unsuccessful due to stone size, impacted position, or anatomical difficulty. The urologist plans an open combined procedure consisting of an incision through the urinary bladder and ureter to extract the ureteral stone (ureterolithotomy via bladder approach) together with resection of the bladder neck to address concomitant obstruction contributing to urinary retention and poor stone clearance.
The clinical workflow includes preoperative evaluation (history, physical, labs, urine culture, imaging such as CT abdomen/pelvis or IVP), informed consent documenting combined procedures, perioperative antibiotic prophylaxis, general or regional anesthesia, intraoperative cystoscopic assessment as needed, a suprapubic or transvesical incision to expose the ureterovesical junction, ureteral incision and stone removal, bladder neck resection (transvesical or transurethral portion as indicated), hemostasis, placement of ureteral stent or drainage catheter if required, and postoperative monitoring for hematuria, infection, and urinary function. Hospital inpatient or ambulatory surgery center status is determined by clinical complexity and comorbidities; this procedure is most commonly performed in an inpatient operating room setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |