Table 1.
Utilization Code Groupings
| Reimbursement | CPT |
|---|---|
| Decreasing | 51726 – Complex cystometrogram |
| 51772 – Urethral pressure profile studies (UPP) | |
| 51785 – Needle electromyography studies (EMG) | |
| 52000 – Cystourethroscopy | |
| 52310 – Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple | |
| 55700 – Biopsy, prostate; needle or punch, single or multiple; any approach | |
| Increasing | 50590 - Lithotripsy, extracorporeal shock wave |
| 51715 - Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder | |
| 51725 – Simple cystometrogram (CMG) | |
| 51741 – Complex uroflowmetry | |
| 51784 – Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique | |
| 51795 – Voiding pressure studies (VP); bladder voiding pressure, any technique | |
| 51797 - intra-abdominal voiding pressure (AP) (rectal, gastric, intraperitoneal) | |
| 52005 – Cystourethroscopy, with ureteral catheterization, with or without irrigation, installation, or ureteropyelography, exclusive of radiologic service | |
| 52204 – Cystourethroscopy, with biopsy | |
| 52214 – Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands | |
| 52224 – Cystourethroscopy with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5cm) lesion(s) with or without biopsy | |
| 52234 - Cystourethroscopy with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) | |
| 52235 - Cystourethroscopy with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 up to 5.0 cm) | |
| 52240 - Cystourethroscopy with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) | |
| 52260 – Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia | |
| 52276 – Cystourethroscopy with direct vision internal urethrotomy | |
| 52281 – Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female | |
| 52315 - Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated | |
| 52332 - Cystourethroscopy, with insertion of indwelling ureteral stent (eg Gibbons or double-J type) | |
| 52351 - Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic | |
| 52352 - Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) | |
| 52353 - Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) | |
| 52500 – Transuretrhal resection of bladder neck (separate procedure) | |
| 52601 – Transuretrhal electrosurgical resection of the prostate, including control of postoperative bleeding, complete | |
| 52648 - Laser vaporization of the prostate, including control of postoperative bleeding, complete | |
| 54161 - Circumcision | |
| 54520 – Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach | |
| 55040 – Excision of hydrocele; unilateral | |
| 55859 - Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy | |