Summary & Overview
CPT 52275: Cystoscopy with Internal Urethrotomy for Urethral Stricture
Headline: CPT code 52275: Endoscopic cystoscopy with internal urethrotomy for male urethral stricture
Lead: CPT code 52275 denotes an endoscopic procedure used to inspect the male urethra and bladder and to incise an internal urethral stricture. This code captures a common urologic intervention that addresses obstructive lower urinary tract symptoms due to focal urethral narrowing.
CPT code 52275 represents an interventional cystoscopy with internal urethrotomy. It matters nationally because urologic endoscopic management of urethral strictures is frequently performed across hospital outpatient departments and ambulatory surgery centers, with implications for coding accuracy, site-of-service classification, and payer coverage policies. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical scope of the code, typical sites of service, and the national relevance for billing and coverage workflows. The publication provides benchmarks for utilization and reimbursement patterns where available, notes common coding and documentation considerations, and summarizes recent policy or payment updates impacting endoscopic urologic procedures. Data limitations: Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 52275 describes a diagnostic and therapeutic endoscopic procedure in which a cystoscope is passed through the male urethra to inspect the urethra, prostatic urethra, bladder interior, and ureteric openings, and an incision is made to release a narrowed area (internal urethral stricture).
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Service type: Endoscopic urethrocystoscopy with internal urethrotomy (stricture incision)
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Typical site of service: Operative suite or ambulatory surgery center for an endoscopic urologic procedure on an adult male
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged to older adult male presenting with lower urinary tract symptoms such as weak urinary stream, straining to void, urinary retention, recurrent urinary tract infections, or a history of urethral instrumentation with progressive obstructive symptoms. Evaluation includes history, physical exam, urinalysis, uroflowmetry, and cystoscopic inspection. The procedure described by 52275 (direct visual inspection with cystoscope and incision of internal urethral stricture) is performed in an ambulatory surgical center or hospital operating room under monitored anesthesia care or general anesthesia. The workflow: preoperative assessment and consent; anesthesia induction; transurethral cystoscopic inspection of the urethra, prostatic urethra, bladder and ureteric orifices; identification of a focal internal urethral stricture; incision of the stricture (cold knife or laser) to restore patency; intraoperative irrigation and hemostasis; placement of a catheter when indicated; post-anesthesia recovery and brief observation for hematuria, urinary retention, or infection. Typical postoperative care includes short-term catheter management, instructions for activity restriction, and follow-up visit to assess voiding and healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or typical service | When the procedure is performed as planned without complications. |