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CPT 51845: Bladder Neck Suspension for Female Stress Urinary Incontinence

CPT code 51845 denotes a bladder neck suspension procedure performed to treat female stress urinary incontinence by anchoring peri‑vesical tissues to the abdominal fibrous tissue. This operative intervention is a recognized surgical option to reduce urine leakage associated with coughing, sneezing, laughing, or exertion and remains relevant in surgical urology and gynecology care pathways.

Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and the kinds of benchmarks and policy considerations payers and providers monitor for this procedure. The publication summarizes common billing modifiers associated with surgical procedures and highlights what is available and what is not: where input fields lacked information, the report notes "Data not available in the input."

The report is organized to help billing managers, surgical clinicians, and policy analysts understand the role of CPT code 51845 in care delivery, reimbursement workflows, and payer coverage discussions. It outlines expected documentation and service settings, offers comparisons across major payers, and flags areas where further data collection would clarify utilization and policy trends.

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Billing Code Overview

CPT code 51845 describes a surgical procedure to treat female stress urinary incontinence by suspending the bladder neck. The surgeon anchors tissues on each side of the bladder neck and sutures them to the fibrous tissue of the abdomen to restore continence during increases in intra‑abdominal pressure.

Service type: Surgical repair for urinary incontinence (bladder neck suspension)
Typical site of service: Hospital operating room or ambulatory surgical center where gynecologic or urologic pelvic surgeries are performed

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CPT 51845: Bladder Neck Suspension for Female Stress Urinary Incontinence

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Sign up for cpt 51845 policy alerts

Get alerted when payer policies referencing 51845 are released or updated.

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Billing Code Overview

Service type: Surgical repair for urinary incontinence (bladder neck suspension)
Typical site of service: Hospital operating room or ambulatory surgical center where gynecologic or urologic pelvic surgeries are performed

Clinical & Coding Specifications

Clinical Context

A 56-year-old parous woman presents with a multi-year history of stress urinary incontinence characterized by urine leakage with coughing, sneezing, laughing, and exercise. Conservative measures including pelvic floor physical therapy and pessary use have failed to produce sustained benefit. Urodynamic testing demonstrates urethral hypermobility without intrinsic sphincter deficiency. The patient elects a bladder neck suspension procedure to elevate and stabilize the bladder neck.

Preoperative workflow includes history and physical, urodynamic study review, informed consent, preoperative anesthesia assessment, and appropriate pre-op labs and imaging as indicated. The procedure is performed in an operating room under general or regional anesthesia. The surgeon identifies periurethral and bladder neck tissues, places sutures on each side of the bladder neck and anchors them to the abdominal (rectus fascia or Cooper's ligament/fascia) fibrous tissue to restore urethral support. Intraoperative cystoscopy may be performed to confirm urethral and bladder integrity. Postoperative workflow includes recovery room monitoring, voiding trial prior to discharge or catheter management, postoperative follow-up for wound check and continence assessment, and documentation of procedure, findings, materials, and any intraoperative complications.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/Not specified	Use when no modifier applies and the payer accepts unmodified codes
`11`	Primary or first-listed procedure	Use when this procedure is the primary service performed during the encounter
`22`	Increased procedural services	Use when the procedure required substantially greater work than usual (document rationale)
`23`	Unusual anesthesia	Use when general anesthesia is required for unusual circumstances (document reason)
`26`	Professional component	Use if reporting only the professional component of a related diagnostic study (rare for this code)
`50`	Bilateral procedure	Use if a payer requires bilateral modifier reporting for procedures that are bilateral by nature (verify payer policy)
`51`	Multiple procedures	Use when additional unrelated procedures are performed on the same day (list secondary codes)
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned (document extent)
`53`	Discontinued procedure	Use when the procedure is started but then aborted for medical reasons (document reason)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during the procedure (document roles)
`63`	Procedure performed on infants less than 4 kg	Generally not applicable to this adult procedure; included if pediatric case occurs
`78`	Unplanned return to OR	Use when the patient returns to the operating room for a related procedure during the global period
`79`	(not provided)	Data not available in the input.
`TC`	Technical component	Use when reporting only the technical component of a related service (rare for this code)

Taxonomy Code	Specialty	Notes
207L00000X	Female Pelvic Medicine & Reconstructive Surgery	Subspecialists who commonly perform bladder neck suspension and pelvic reconstructive procedures
208100000X	Obstetrics & Gynecology	Gynecologic surgeons frequently perform continence procedures in adult women
208VP0000X	Urology	Urologists commonly perform anti-incontinence and bladder neck suspension procedures
207R00000X	Colon & Rectal Surgery	May be involved when concomitant pelvic floor reconstructive work is required
2080P0212X	General Surgery	General surgeons with pelvic surgery expertise may perform in select settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N39.3`	Stress incontinence (female)	Primary indication for bladder neck suspension to correct urethral hypermobility and reduce leakage with exertion
`N39.41`	Urge incontinence	Differentiation from stress incontinence is important; mixed incontinence may alter surgical candidacy
`N39.46`	Mixed incontinence (urge and stress)	Patients with mixed symptoms require careful evaluation; bladder neck suspension addresses stress component
`N81.3`	Cystocele (anterior vaginal wall prolapse)	Anterior prolapse often coexists with stress incontinence and may be repaired concurrently with suspension
`N81.4`	Enterocele	Pelvic organ prolapse component that may be addressed during pelvic reconstructive surgery involving bladder support
`R32`	Unspecified urinary incontinence	Used when documentation lacks specificity; further clarification recommended for accurate coding
`O00-O9A`	Pregnancy-related codes (general class)	Pregnancy and postpartum conditions can cause or influence incontinence; surgical timing considerations apply

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51702`	Complex urethral reconstruction; without graft (eg, urethral/bladder neck repair)	May be performed when simultaneous urethral reconstruction is necessary with bladder neck suspension
`52000`	Cystourethroscopy, with or without irrigation and/or instillation; diagnostic, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy often performed before or after suspension to evaluate bladder and urethra integrity
`51990`	Testing of urinary continence using pad test or other objective measures (Note: placeholder for related testing codes)	Used in pre- or postoperative assessment of continence outcomes (use payer-specific test codes)
`57425`	Colposcopy of the cervix including upper/adjacent vaginal mucosa when performed; with biopsy(s) of the cervix and/or endocervical curettage	Occasionally performed concurrently if gynecologic indications exist during the same operative session
`99024`	Postoperative follow-up visit, global surgery package	Applies to routine postoperative visits included in the global period for surgical procedures

CPT 51800: Bladder, Vesical Neck and Urethral Repair, Open Surgical Reconstruction

CPT-51820-BLADDER-URETHRAL-REPAIR-URETERAL-REIMPLANTATION

CPT 51820: Bladder and Urethral Repair with Ureteral Reimplantation

CPT-51840-URETHROPEXY-BLADDER-NECK-ELEVATION

CPT 51840: Urethropexy (Bladder Neck Elevation)

CPT-51841-ANTERIOR-VESICOURETHROPEXY-URETHROPEXY-ELEVATION-FIXATION

CPT 51841: Anterior Vesicourethropexy/Urethropexy for Urinary Incontinence

CPT-51860-OPEN-BLADDER-REPAIR-SIMPLE-WOUND

CPT 51860: Open Repair of Simple Bladder Wound

CPT-51865-COMPLEX-OPEN-BLADDER-REPAIR

CPT 51865: Complex Open Repair of Urinary Bladder

CPT-51880-CYSTOSTOMY-TUBE-REMOVAL-AND-BLADDER-CLOSURE

CPT 51880: Removal of Cystostomy Tube with Bladder Closure

CPT-51900-VESICOVAGINAL-URETHROVAGINAL-FISTULA-REPAIR

CPT 51900: Vesicovaginal and Urethrovaginal Fistula Repair

CPT-51920-VESICOUTERINE-FISTULA-REPAIR

CPT 51920: Vesicouterine Fistula Excision and Repair

CPT-51925-VESICOUTERINE-FISTULA-EXCISION-WITH-HYSTERECTOMY

CPT 51925: Excision of Vesicouterine Fistula with Hysterectomy

Showing 1–10 of 13

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.

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`	Default/Not specified	Use when no modifier applies and the payer accepts unmodified codes
`11`	Primary or first-listed procedure	Use when this procedure is the primary service performed during the encounter
`22`	Increased procedural services	Use when the procedure required substantially greater work than usual (document rationale)
`23`	Unusual anesthesia	Use when general anesthesia is required for unusual circumstances (document reason)
`26`	Professional component	Use if reporting only the professional component of a related diagnostic study (rare for this code)
`50`	Bilateral procedure	Use if a payer requires bilateral modifier reporting for procedures that are bilateral by nature (verify payer policy)
`51`	Multiple procedures	Use when additional unrelated procedures are performed on the same day (list secondary codes)
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned (document extent)
`53`	Discontinued procedure	Use when the procedure is started but then aborted for medical reasons (document reason)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during the procedure (document roles)
`63`	Procedure performed on infants less than 4 kg	Generally not applicable to this adult procedure; included if pediatric case occurs
`78`	Unplanned return to OR	Use when the patient returns to the operating room for a related procedure during the global period
`79`	(not provided)	Data not available in the input.
`TC`	Technical component	Use when reporting only the technical component of a related service (rare for this code)

Taxonomy Code	Specialty	Notes
207L00000X	Female Pelvic Medicine & Reconstructive Surgery	Subspecialists who commonly perform bladder neck suspension and pelvic reconstructive procedures
208100000X	Obstetrics & Gynecology	Gynecologic surgeons frequently perform continence procedures in adult women
208VP0000X	Urology	Urologists commonly perform anti-incontinence and bladder neck suspension procedures
207R00000X	Colon & Rectal Surgery	May be involved when concomitant pelvic floor reconstructive work is required
2080P0212X	General Surgery	General surgeons with pelvic surgery expertise may perform in select settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N39.3`	Stress incontinence (female)	Primary indication for bladder neck suspension to correct urethral hypermobility and reduce leakage with exertion
`N39.41`	Urge incontinence	Differentiation from stress incontinence is important; mixed incontinence may alter surgical candidacy
`N39.46`	Mixed incontinence (urge and stress)	Patients with mixed symptoms require careful evaluation; bladder neck suspension addresses stress component
`N81.3`	Cystocele (anterior vaginal wall prolapse)	Anterior prolapse often coexists with stress incontinence and may be repaired concurrently with suspension
`N81.4`	Enterocele	Pelvic organ prolapse component that may be addressed during pelvic reconstructive surgery involving bladder support
`R32`	Unspecified urinary incontinence	Used when documentation lacks specificity; further clarification recommended for accurate coding
`O00-O9A`	Pregnancy-related codes (general class)	Pregnancy and postpartum conditions can cause or influence incontinence; surgical timing considerations apply

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51702`	Complex urethral reconstruction; without graft (eg, urethral/bladder neck repair)	May be performed when simultaneous urethral reconstruction is necessary with bladder neck suspension
`52000`	Cystourethroscopy, with or without irrigation and/or instillation; diagnostic, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy often performed before or after suspension to evaluate bladder and urethra integrity
`51990`	Testing of urinary continence using pad test or other objective measures (Note: placeholder for related testing codes)	Used in pre- or postoperative assessment of continence outcomes (use payer-specific test codes)
`57425`	Colposcopy of the cervix including upper/adjacent vaginal mucosa when performed; with biopsy(s) of the cervix and/or endocervical curettage	Occasionally performed concurrently if gynecologic indications exist during the same operative session
`99024`	Postoperative follow-up visit, global surgery package	Applies to routine postoperative visits included in the global period for surgical procedures

CPT 51800: Bladder, Vesical Neck and Urethral Repair, Open Surgical Reconstruction

CPT-51820-BLADDER-URETHRAL-REPAIR-URETERAL-REIMPLANTATION

CPT 51820: Bladder and Urethral Repair with Ureteral Reimplantation

CPT-51840-URETHROPEXY-BLADDER-NECK-ELEVATION

CPT 51840: Urethropexy (Bladder Neck Elevation)

CPT-51841-ANTERIOR-VESICOURETHROPEXY-URETHROPEXY-ELEVATION-FIXATION

CPT 51841: Anterior Vesicourethropexy/Urethropexy for Urinary Incontinence

CPT-51860-OPEN-BLADDER-REPAIR-SIMPLE-WOUND

CPT 51860: Open Repair of Simple Bladder Wound

CPT-51865-COMPLEX-OPEN-BLADDER-REPAIR

CPT 51865: Complex Open Repair of Urinary Bladder

CPT-51880-CYSTOSTOMY-TUBE-REMOVAL-AND-BLADDER-CLOSURE

CPT 51880: Removal of Cystostomy Tube with Bladder Closure

CPT-51900-VESICOVAGINAL-URETHROVAGINAL-FISTULA-REPAIR

CPT 51900: Vesicovaginal and Urethrovaginal Fistula Repair

CPT-51920-VESICOUTERINE-FISTULA-REPAIR

CPT 51920: Vesicouterine Fistula Excision and Repair

CPT-51925-VESICOUTERINE-FISTULA-EXCISION-WITH-HYSTERECTOMY

CPT 51925: Excision of Vesicouterine Fistula with Hysterectomy

Showing 1–10 of 13

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.

OpenPayer

CPT 51845: Bladder Neck Suspension for Female Stress Urinary Incontinence

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Billing Code Overview

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OpenPayer

CPT 51845: Bladder Neck Suspension for Female Stress Urinary Incontinence

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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