Summary & Overview
CPT 52284: Urethral Dilation with Drug-Coated Balloon Catheter
CPT code 52284 represents an endoscopic urethral dilation procedure that uses a cystourethroscope and a drug‑coated balloon catheter to dilate a urethral stricture and deliver a therapeutic agent directly to the urethra. This targeted approach may reduce the need for repeat dilation and offers a combined mechanical and pharmacologic treatment option. Nationally, the code is relevant for urology practices, ambulatory surgical centers, and hospital outpatient departments that manage male patients with symptomatic urethral narrowing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical service settings, plus benchmarking and policy-relevant topics: utilization patterns, payer coverage trends, coding and billing considerations, and implications for practice workflow and patient selection. Where available, comparisons across major payers highlight coverage nuances and prior authorization trends.
This summary provides a practical reference for clinicians, coding professionals, and policy analysts seeking to understand how CPT code 52284 fits into current urologic treatment pathways and payer landscapes. Data not available in the input.
Billing Code Overview
CPT code 52284 describes a cystourethroscopic procedure using a drug-coated balloon catheter to dilate a urethral stricture and deliver a therapeutic drug directly to the urethra. The procedure is performed using a cystourethroscope and may include fluoroscopic guidance when needed.
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Service type: Endoscopic urethral dilation with local drug delivery
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Typical site of service: Ambulatory surgical center or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of prior transurethral prostate procedures presents with progressive obstructive voiding symptoms, decreased urinary stream, and intermittent urinary retention. On evaluation he has uroflowmetry showing reduced peak flow and cystourethroscopy confirming a short-segment bulbar urethral stricture approximately 1.5 cm in length. Conservative management with dilation and intermittent self-catheterization has failed. The urologist schedules a minimally invasive endoscopic urethral dilation using a cystourethroscope and a drug-coated balloon catheter to mechanically dilate the stricture and locally deliver an antiproliferative agent to reduce restenosis risk.
The procedure is typically performed in an ambulatory surgery center or hospital operating room under monitored anesthesia care or general anesthesia. Fluoroscopy may be used for additional guidance. The workflow includes preoperative consent and antibiotic prophylaxis per facility protocol, cystourethroscopy for visualization and stricture measurement, passage and inflation of the drug-coated balloon across the stricture under direct vision (with optional fluoroscopic confirmation), deflation and removal of the balloon, reassessment of urethral patency, and placement of a short-term catheter if indicated. Postoperative instructions address voiding trials, analgesia, and follow-up uroflow or cystoscopy to monitor recurrence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier applicable | Use as default when no specific modifier applies (note: rarely used clinically). |