Summary & Overview

CPT 52344: Cystourethroscopy with Ureteral Stricture Treatment

CPT code 52344 denotes a cystourethroscopy combined with targeted treatment of a ureteral stricture and additional ureteroscopic evaluation. This endoscopic urology procedure is used to inspect the bladder, urethra, prostatic urethra, and ureteric openings and to insert a catheter tip into the ureteral orifice to deliver a chosen method of stricture management while using a ureteroscope for further visualization. The code matters nationally because it captures a common diagnostic-therapeutic intervention for ureteral obstruction and stricture that affects procedure coding, resource utilization, and claims adjudication across payers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context and typical sites of service, plus an outline of billing considerations and common modifiers used with the code. The publication provides benchmarks and utilization context, highlights relevant policy or coverage themes affecting endoscopic ureteral procedures, and explains how CPT code 52344 relates to related endoscopic urologic services. Data gaps in the input are noted where necessary.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare52344CPTurologycystourethroscopyureteroscopyureteral strictureendoscopyambulatory surgery

Billing Code Overview

CPT code 52344 describes a cystourethroscopy with diagnostic inspection of the bladder, urethra, prostatic urethra, and ureteral orifices using a cystoscope, with catheter tip insertion into the ureteral opening to perform treatment of a ureteral stricture and use of a ureteroscope for further visualization of the ureters.

Service type: Endoscopic urologic procedure for diagnosis and treatment of ureteral stricture
Typical site of service: Ambulatory surgery center or hospital outpatient department; may also be performed in a physician office with appropriate endoscopic equipment

Clinical & Coding Specifications

Clinical Context

A 58-year-old male with a history of recurrent flank pain and progressive hydronephrosis is evaluated for suspected ureteral stricture after prior ureteroscopy and stone extraction. Imaging (CT urogram) demonstrates focal narrowing of the distal ureter with upstream dilation and impaired drainage. The urology team schedules a cystourethroscopy with ureteroscopy and possible endoscopic management of the ureteral stricture.

During the procedure performed in an ambulatory surgery center or hospital operating room under general or regional anesthesia, the surgeon inserts a cystoscope through the urethra to inspect the urethra, prostatic urethra, and bladder. The ureteral orifice is identified and a catheter tip is passed into the ureteral opening; a ureteroscope is advanced for direct visualization of the ureteral lumen. Endoscopic techniques (balloon dilation, cold knife incision, endoureterotomy, or stent placement) are selected based on stricture location, length, and tissue characteristics. Fluoroscopy and contrast may be used for guidance. Postprocedure care includes monitoring for hematuria, pain control, and instructions if a ureteral stent was placed for temporary drainage.

Coding Specifications

Modifier	Description	When to Use
`11`	Standard procedure performed	Use when the service represents the usual, uncomplicated procedure by the performing surgeon.
`22`	Increased procedural services	Use when the procedure requires substantially greater work than typical (e.g., extensive lysis of adhesions, prolonged operative time) and documentation supports increased work.
`23`	Unusual anesthesia	Use when the procedure is performed under general anesthesia solely because of an unusual circumstance and anesthesia is not otherwise typical.
`52`	Reduced services	Use when the documented service was partially reduced or not completed as planned (e.g., aborted attempt to treat stricture).
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances or patient instability.
`58`	Staged or related procedure by the same physician during postoperative period	Use when this procedure is planned as a staged approach following an initial procedure.
`59`	Distinct procedural service	Use when another procedure performed on the same day is distinct and separate from the cystourethroscopy/ureteroscopy.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`73`	Discontinued outpatient hospital/ASC procedure prior to anesthesia	Use when the outpatient/ASC procedure is discontinued before anesthesia administration.
`74`	Discontinued outpatient hospital/ASC procedure after anesthesia	Use when the outpatient/ASC procedure is discontinued after anesthesia is administered.
`78`	Return to OR for related procedure during postoperative period	Use when a related unplanned return to the operating room occurs for complications.
`80`	Assistant surgeon present	Use when an assistant surgeon performs part of the procedure.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`TG`	Ambulance ground mileage (if applicable to transport billing)	Use in documentation when ground transport services are billed in conjunction with a procedure (site-dependent).

Taxonomy Code	Specialty	Notes
`2080S0100X`	Urology	Primary specialty performing cystourethroscopy with ureteroscopy and endoscopic ureteral procedures.
`2083P0900X`	Pediatric Urology	Performs similar procedures in pediatric populations when indicated.
`208000000X`	General Surgery	Occasionally performs endourologic procedures in specific practice settings.
`2084P0700X`	Female Pelvic Medicine & Reconstructive Surgery	May perform cystoscopic evaluations in related pelvic reconstructive workflows.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydroureter, not elsewhere classified	Hydroureter indicates upstream dilation from ureteral obstruction; commonly evaluated and treated during ureteroscopy and stricture management.
`N13.5`	Hydronephrosis with ureteral stricture	Directly describes hydronephrosis secondary to ureteral stricture — a primary indication for endoscopic evaluation and treatment.
`N13.7`	Other obstructive and reflux uropathy	Covers obstructive processes requiring cystourethroscopy and ureteroscopic assessment.
`N20.0`	Calculus of kidney	Associated when stones have caused ureteral injury or obstruction and require concurrent ureteroscopy.
`N28.9`	Disorder of kidney and ureter, unspecified	Used when specific disorder is not otherwise classified but evaluation with cystourethroscopy/ureteroscopy is clinically indicated.
`N32.0`	Hypertrophy of prostate	Prostatic urethra evaluation during cystourethroscopy may be indicated in men with concomitant prostatic obstruction contributing to urinary symptoms.
`N34.2`	Urethral stricture	Primary diagnosis when stricture of the urethra contributes to obstructive uropathy and is assessed during cystourethroscopy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy; diagnostic, with or without collection of specimen(s) by brushing or washing	May be performed when only diagnostic cystoscopy is needed without ureteral catheterization or ureteroscopy.
`52005`	Cystourethroscopy with ureteral catheterization, with or without irrigation and/or ureteropyelography	Used when ureteral catheterization and contrast study are performed without ureteroscopy or definitive endoscopic stricture management.
`52352`	Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal of ureteral calculus	Performed when ureteroscopic stone removal is required in addition to diagnostic evaluation.
`50660`	Ureteral stent placement, with or without repositioning	May be performed immediately after endoscopic stricture treatment to maintain ureteral patency.
`52287`	Endoscopic lysis of ureteral stricture by laser or other means	Used for specific endoureterotomy or stricture incision techniques performed via ureteroscopy.
`51800`	Insertion of temporary indwelling bladder catheter; simple (e.g., Foley catheter)	May be performed perioperatively for bladder drainage following cystourethroscopy/ureteroscopy.