Summary & Overview
CPT 52007: Cystourethroscopy with Ureter/Renal Pelvis Brush Biopsy
CPT code 52007 represents an endoscopic urologic procedure: a cystourethroscopy with inspection of the bladder, urethra, and ureteric pelvis and brush biopsy of the ureter and/or renal pelvis. This code captures diagnostic visualization combined with tissue sampling from the upper urinary tract and is relevant for evaluation of hematuria, suspected urothelial carcinoma, or other pathology of the ureter or renal pelvis. Nationally, reporting of this code affects clinical documentation, bundling considerations with radiologic imaging, and claims for urology procedural services.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for utilization and payment practice context, an explanation of clinical indications and procedure components, and notes on common billing considerations such as separate reporting of radiologic services when performed. The publication summarizes where CPT code 52007 fits within urologic endoscopy service lines and highlights operational points that influence coding and claims submission across major national payers.
Billing Code Overview
CPT code 52007 describes a cystourethroscopy with inspection of the bladder, urethra, and ureteric pelvis and performance of a biopsy of the ureter and/or renal pelvis using a brush passed through the scope. The procedure may include bladder irrigation, instillation of fluids, or imaging of the ureter and renal pelvis, although any radiologic services performed should be reported separately.
Service type: Endoscopic diagnostic procedure with tissue sampling (ureter/renal pelvis brush biopsy)
Typical site of service: Hospital outpatient department or ambulatory surgical center, and may also be performed in urology specialty clinics equipped for endoscopic procedures.
Clinical & Coding Specifications
Clinical Context
A 67-year-old male with gross hematuria and a history of smoking is scheduled for cystourethroscopy with ureteric brush biopsy (52007) performed by a urologist in an outpatient endoscopy suite. Pre-procedure evaluation includes urinalysis, urine culture, and cross-sectional imaging (CT urogram) identifying a filling defect in the renal pelvis. Under monitored anesthesia care, a flexible cystoscope is advanced to inspect the bladder and urethra. The ureteral orifice is cannulated, a ureteroscope advanced into the ureter and renal pelvis as needed, and a cytology brush is passed through the working channel to obtain brush biopsies of the ureter and/or renal pelvis. The provider may irrigate the bladder and instill topical agents during the procedure. Fluoroscopic imaging or formal radiologic contrast studies are performed separately as indicated and billed independently. Post-procedure, the patient is observed in recovery, receives discharge instructions about hematuria and infection signs, and outpatient pathology follow-up is arranged for cytology results.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal/standard service | Use when 52007 performed without unusual services or complications |