CPT code 51065 denotes an open bladder incision to remove a ureteral calculus, often employing a calculus basket and fragmentation methods (ultrasonic or electrohydraulic). This procedure is an important component of urologic surgical care for stones that cannot be managed endoscopically or fragmented and passed with less invasive techniques. Nationally, the code captures resource use, hospital and ambulatory surgery billing, and inform coverage decisions for higher-complexity stone management.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 51065 is used, typical sites of service, common billing modifiers and payer considerations, and related coding guidance where available. The publication outlines benchmarks for utilization and payment patterns where data is available and summarizes policy and coverage drivers affecting access to surgical stone removal. Clinical context addresses the procedural steps implied by the code and typical care settings, helping coding and billing professionals, urology clinicians, and policy analysts understand implications for claims, documentation, and payer interactions.

Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, specific service-line details.