Find policies, billing codes, payers, states, and providers

CPT 52640: Endoscopic Removal of Bladder Neck Contracture

CPT code 52640 covers endoscopic surgical removal of bladder neck contracture, a complication frequently seen after prostatectomy. The code captures a focused urologic procedure to excise or incise scar tissue at the bladder outlet to restore urinary flow. Nationally, management of bladder neck contracture affects surgical practice patterns, device use, and post-prostatectomy care pathways in both inpatient and ambulatory surgery settings.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context explaining when endoscopic BNC removal is used, the typical sites of service, and which payer types commonly cover the procedure. The publication provides benchmarks and coding context useful for billing, claims adjudication, and policy review, and highlights how this procedure fits into postoperative urologic care pathways.

The content outlines expected service lines, common procedural context after prostatectomy, and payer coverage themes. Data not available in the input is clearly identified where applicable.

Customize your policy alerts

Sign up for cpt 52640 policy alerts

Get alerted when payer policies referencing 52640 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 52640 describes endoscopic removal of a postoperative bladder neck contracture (BNC). Bladder neck contracture most commonly occurs after prostatectomy; the procedure removes scar tissue or fibrotic obstruction at the bladder outlet using an endoscopic approach.

Service type: Endoscopic surgical procedure for bladder neck stricture/contracture
Typical site of service: Ambulatory surgery center or hospital operating room with endoscopic urology capability

Find policies, billing codes, payers, states, and providers

CPT 52640: Endoscopic Removal of Bladder Neck Contracture

The content outlines expected service lines, common procedural context after prostatectomy, and payer coverage themes. Data not available in the input is clearly identified where applicable.

Customize your policy alerts

Sign up for cpt 52640 policy alerts

Get alerted when payer policies referencing 52640 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Endoscopic surgical procedure for bladder neck stricture/contracture
Typical site of service: Ambulatory surgery center or hospital operating room with endoscopic urology capability

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old man with a history of radical prostatectomy six to twelve months prior who presents with progressive lower urinary tract symptoms and difficulty voiding. Cystoscopic evaluation reveals a bladder neck contracture (BNC) causing obstruction. The urology team schedules a transurethral endoscopic procedure for removal of the contracture under general or regional anesthesia. Preoperative workflow includes history and focused exam, urinalysis or urine culture, cessation of anticoagulants as indicated, informed consent, and anesthesia evaluation. In the operating room or ambulatory surgery center, the patient undergoes cystoscopic visualization and endoscopic incision or resection of the contracture using cold knife, electrocautery, or laser techniques. A Foley catheter is typically placed postprocedure for short-term bladder drainage. Postoperative care includes monitoring for hematuria, infection prophylaxis per protocol, catheter management, and urology follow-up to assess urinary flow and healing. Typical sites of service are the ambulatory surgery center or hospital outpatient department; the service type is endoscopic surgical procedure of the lower urinary tract.

Coding Specifications

Modifier	Description	When to Use
`00`	Undefined/Not used in standard Medicare reporting	Data not clinically used; included in raw list but not applicable for standard reporting
`11`	Office or outpatient E/M — CMS nonstandard; often internal tracking	Rarely appended; use per payer policy if required for internal editing
`22`	Increased procedural services	Use when work or complexity substantially greater than usual (document rationale)
`23`	Unusual anesthesia	Use if procedure performed under general anesthesia due to medical condition when local/regional would normally be used
`26`	Professional component	Use when billing physician component separately from technical facility component
`50`	Bilateral procedure	Use if bilateral work is legitimately performed and payer allows modifier for bilateral endoscopic work
`51`	Multiple procedures	Use when multiple distinct procedures performed at same session in addition to primary code
`52`	Reduced services	Use when procedure was partially reduced or not completed as planned
`53`	Discontinued procedure	Use when procedure terminated due to patient condition or intraoperative complications
`58`	Staged or related procedure or service by same physician during postoperative period	Use when procedure is planned as staged or more extensive procedure follows within global period
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure when multiple procedures are reported the same day (avoid misuse)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons on the same procedure
`63`	Procedure performed on infants less than 4 kg	Typically not applicable to adult urology procedures

Taxonomy Code	Specialty	Notes
207RH0000X	Urology	Primary specialty performing transurethral bladder neck incisions/resections
208000000X	General Surgery	May perform urologic endoscopic procedures in some institutions; less common
207RP2900X	Female Pelvic Medicine & Reconstructive Surgery	In settings with pelvic reconstructive overlap; occasional involvement for complex lower urinary tract reconstruction
2084P0800X	Surgical Oncology	In cases where prostate cancer recurrence or complex oncologic reconstruction is involved
364S00000X	Anesthesiology	Provides anesthesia services for the endoscopic procedure

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52204`	Cystourethroscopy, with removal of foreign body or tumor from bladder; with fulguration/laser ablation, single or multiple tumors	May be used when concurrent bladder tumor removal or fulguration is performed at time of bladder neck incision/resection
`52000`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy performed preoperatively or intraoperatively to evaluate bladder neck contracture
`52005`	Cystourethroscopy, with dilation of urethral stricture, with or without direct vision internal urethrotomy	Alternative or adjunct procedure when urethral stricture coexists with bladder neck contracture
`52235`	Cystourethroscopy with TUR of bladder neck or prostate, including fulguration	Related endoscopic resection techniques that may be performed when resection of obstructing tissue is required
`53420`	Revision of bladder neck contracture (open)	Open surgical revision may be required for recurrent or refractory contractures after endoscopic management

CPT 52400: Cystourethroscopy via Cystoscope

CPT-52402-EJACULATORY-DUCT-ENDOSCOPIC-EXCISION-OR-INCISION

CPT 52402: Cystoscopic Excision or Incision of Ejaculatory Duct

CPT-52441-TRANSPROSTATIC-IMPLANT-PLACEMENT-CYSTOURETHROSCOPIC

CPT 52441: Cystourethroscopic Placement of Permanent Transprostatic Implant

CPT-52442-TRANSPROSTATIC-IMPLANT-ADD-ON-PLACEMENT

CPT 52442: Additional Transprostatic Implant Placement

CPT-52443-BALLOON-DILATION-AND-DRUG-COATED-BALLOON-PROSTATE

CPT 52443: Cystoscopy with Balloon Dilation and Drug-Coated Balloon Prostate Delivery

CPT-52450-TRANSURETHRAL-PROSTATE-CAPSULOTOMY-ENDOSCOPIC-INCISION

CPT 52450: Transurethral Prostate Capsule Incision to Relieve Obstruction

CPT-52500-CYSTOURETHROSCOPY-TRANSURETHRAL-EXCISION-BLADDER-NECK

CPT 52500: Cystourethroscopy with Transurethral Excision of Bladder Neck

CPT-52597-ROBOTIC-WATERJET-PROSTATE-TISSUE-REMOVAL-THROUGH-URETHRA

CPT 52597: Robotic Waterjet Prostate Tissue Removal

CPT-52601-TRANSURETHRAL-RESECTION-PROSTATE-TURP

CPT 52601: Transurethral Resection of Prostate (TURP)

CPT-52630-PROSTATE-RESECTION-RESIDUAL-TISSUE

CPT 52630: Resection of Residual or Regrown Prostate Tissue

Showing 1–10 of 13

Frequently Asked Questions

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`	Undefined/Not used in standard Medicare reporting	Data not clinically used; included in raw list but not applicable for standard reporting
`11`	Office or outpatient E/M — CMS nonstandard; often internal tracking	Rarely appended; use per payer policy if required for internal editing
`22`	Increased procedural services	Use when work or complexity substantially greater than usual (document rationale)
`23`	Unusual anesthesia	Use if procedure performed under general anesthesia due to medical condition when local/regional would normally be used
`26`	Professional component	Use when billing physician component separately from technical facility component
`50`	Bilateral procedure	Use if bilateral work is legitimately performed and payer allows modifier for bilateral endoscopic work
`51`	Multiple procedures	Use when multiple distinct procedures performed at same session in addition to primary code
`52`	Reduced services	Use when procedure was partially reduced or not completed as planned
`53`	Discontinued procedure	Use when procedure terminated due to patient condition or intraoperative complications
`58`	Staged or related procedure or service by same physician during postoperative period	Use when procedure is planned as staged or more extensive procedure follows within global period
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure when multiple procedures are reported the same day (avoid misuse)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons on the same procedure
`63`	Procedure performed on infants less than 4 kg	Typically not applicable to adult urology procedures

Taxonomy Code	Specialty	Notes
207RH0000X	Urology	Primary specialty performing transurethral bladder neck incisions/resections
208000000X	General Surgery	May perform urologic endoscopic procedures in some institutions; less common
207RP2900X	Female Pelvic Medicine & Reconstructive Surgery	In settings with pelvic reconstructive overlap; occasional involvement for complex lower urinary tract reconstruction
2084P0800X	Surgical Oncology	In cases where prostate cancer recurrence or complex oncologic reconstruction is involved
364S00000X	Anesthesiology	Provides anesthesia services for the endoscopic procedure

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52204`	Cystourethroscopy, with removal of foreign body or tumor from bladder; with fulguration/laser ablation, single or multiple tumors	May be used when concurrent bladder tumor removal or fulguration is performed at time of bladder neck incision/resection
`52000`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	Diagnostic cystoscopy performed preoperatively or intraoperatively to evaluate bladder neck contracture
`52005`	Cystourethroscopy, with dilation of urethral stricture, with or without direct vision internal urethrotomy	Alternative or adjunct procedure when urethral stricture coexists with bladder neck contracture
`52235`	Cystourethroscopy with TUR of bladder neck or prostate, including fulguration	Related endoscopic resection techniques that may be performed when resection of obstructing tissue is required
`53420`	Revision of bladder neck contracture (open)	Open surgical revision may be required for recurrent or refractory contractures after endoscopic management

CPT 52400: Cystourethroscopy via Cystoscope

CPT-52402-EJACULATORY-DUCT-ENDOSCOPIC-EXCISION-OR-INCISION

CPT 52402: Cystoscopic Excision or Incision of Ejaculatory Duct

CPT-52441-TRANSPROSTATIC-IMPLANT-PLACEMENT-CYSTOURETHROSCOPIC

CPT 52441: Cystourethroscopic Placement of Permanent Transprostatic Implant

CPT-52442-TRANSPROSTATIC-IMPLANT-ADD-ON-PLACEMENT

CPT 52442: Additional Transprostatic Implant Placement

CPT-52443-BALLOON-DILATION-AND-DRUG-COATED-BALLOON-PROSTATE

CPT 52443: Cystoscopy with Balloon Dilation and Drug-Coated Balloon Prostate Delivery

CPT-52450-TRANSURETHRAL-PROSTATE-CAPSULOTOMY-ENDOSCOPIC-INCISION

CPT 52450: Transurethral Prostate Capsule Incision to Relieve Obstruction

CPT-52500-CYSTOURETHROSCOPY-TRANSURETHRAL-EXCISION-BLADDER-NECK

CPT 52500: Cystourethroscopy with Transurethral Excision of Bladder Neck

CPT-52597-ROBOTIC-WATERJET-PROSTATE-TISSUE-REMOVAL-THROUGH-URETHRA

CPT 52597: Robotic Waterjet Prostate Tissue Removal

CPT-52601-TRANSURETHRAL-RESECTION-PROSTATE-TURP

CPT 52601: Transurethral Resection of Prostate (TURP)

CPT-52630-PROSTATE-RESECTION-RESIDUAL-TISSUE

CPT 52630: Resection of Residual or Regrown Prostate Tissue

Showing 1–10 of 13

Frequently Asked Questions

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 52640: Endoscopic Removal of Bladder Neck Contracture

Sign up for cpt 52640 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 52640: Endoscopic Removal of Bladder Neck Contracture

Sign up for cpt 52640 policy alerts

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

CPT 52640: Endoscopic Removal of Bladder Neck Contracture

Sign up for cpt 52640 policy alerts

Billing Code Overview

CPT 52640: Endoscopic Removal of Bladder Neck Contracture

Sign up for cpt 52640 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation and procedure does CPT 52640 cover?

Where is this procedure usually performed and what are common perioperative steps?

Which related CPT codes should be considered when coding services performed with or instead of 52640?

What modifiers are listed that might apply to CPT 52640 and when would they be used?

Which specialties perform CPT 52640 and which payers are commonly referenced?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation and procedure does CPT 52640 cover?

Where is this procedure usually performed and what are common perioperative steps?

Which related CPT codes should be considered when coding services performed with or instead of 52640?

What modifiers are listed that might apply to CPT 52640 and when would they be used?

Which specialties perform CPT 52640 and which payers are commonly referenced?

References