Summary & Overview
CPT 53855: Urethral Stent Insertion for Prostatic Urethral Support
CPT code 53855 covers insertion of a sterile, disposable urethral stent placed to prevent collapse of the urethra and maintain urinary flow, most commonly used to support the prostatic urethra after obstructive swelling from treatment for benign prostatic hyperplasia (BPH). This procedure is clinically significant because it addresses acute postoperative urinary obstruction and can reduce the need for catheterization or repeat procedures, with implications for patient recovery and resource use across surgical settings.
Key payers included in the national analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how CPT code 53855 is billed across typical sites of service (ambulatory surgical centers and hospital operating rooms) and by urology specialists.
Readers will find concise benchmarks and contextual information on utilization patterns, coding considerations, and the clinical circumstances prompting stent insertion for prostatic urethral support. The summary highlights common billing modifiers and payer mix considerations where available. Data not available in the input are noted where relevant. The content is intended to inform coding, billing, and policy stakeholders about the clinical role and administrative handling of CPT code 53855 at a national level.
Billing Code Overview
CPT code 53855 describes insertion of a sterile, disposable urethral stent to prevent urethral collapse and maintain urinary flow. The procedure is performed primarily to support and keep patent the prostatic urethra after obstructive swelling of the prostate following treatment for benign prostatic hyperplasia.
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Service type: Urethral stent insertion for prostatic urethral support
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Typical site of service: Ambulatory surgical center or hospital operating room, performed by a urology specialist
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male who undergoes transurethral resection of the prostate (TURP) or other prostate-directed therapy for symptomatic benign prostatic hyperplasia and develops immediate postoperative prostatic urethral edema or obstruction that compromises urinary outflow. The urology team places a temporary urethral stent to support and keep patent the prostatic urethra, allowing adequate urine drainage while swelling resolves. The workflow includes pre-procedure verification, informed consent, sterile field preparation in an ambulatory surgery center or hospital operating room, insertion of a sterile disposable urethral stent under cystoscopic visualization with local or general anesthesia, confirmation of correct positioning and urine flow, and post-procedure monitoring for hematuria, dysuria, urinary retention, or infection. Typical site of service is an ambulatory surgery center or inpatient/outpatient operating room. The service type is a surgical implant/procedure to maintain urethral patency following obstructive prostatic swelling.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the urethral stent insertion is partially reduced or not completed as originally planned. |
53 |