© Copyright 2025 American Medical Association. All rights reserved.
Balloon dilation of a ureteral stricture is a minimally invasive procedure aimed at widening narrowed segments of the ureter, which can obstruct the flow of urine. The ureter is a tube that carries urine from the kidneys to the bladder, and strictures can occur due to various factors, including tumors or fibrosis, leading to significant complications if left untreated. The procedure can be performed using two primary approaches: through a percutaneously placed catheter or via the bladder using a ureteroscope. In both methods, radiologic guidance, such as ultrasound or fluoroscopy, is essential to accurately position the balloon over the stricture, ensuring effective dilation. During the procedure, if a percutaneous approach is utilized, a trocar or Chiba needle is inserted under imaging guidance to access the renal pelvis, allowing for urine aspiration to confirm the correct location and relieve any pressure in the urinary system. A guidewire is then threaded to the stricture, followed by the placement of a balloon catheter over the guidewire. The balloon is inflated to dilate the stricture, and a stent may be placed afterward to maintain ureteral patency. If the ureteroscope approach is chosen, the balloon catheter is directly introduced through the cystoscope, and similar steps are followed to ensure the stricture is adequately treated. The procedure is comprehensive, including all necessary imaging guidance and radiological supervision, which are integral to the successful outcome of the balloon dilation of a ureteral stricture.
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Balloon dilation of a ureteral stricture is indicated for patients presenting with the following conditions:
The procedure for balloon dilation of a ureteral stricture involves several critical steps to ensure successful treatment:
After the balloon dilation procedure, patients may require monitoring for any complications, such as bleeding or infection. It is essential to assess the patient's recovery and ensure that the ureter remains patent. Follow-up imaging may be necessary to confirm the success of the dilation and the placement of any stents. Patients should be advised on signs of potential complications, such as changes in urine output or symptoms of infection, and instructed to follow up with their healthcare provider as needed.
| Short Descr | BALLOON DILATE URTRL STRIX | Medium Descr | BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I | Long Descr | Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 2 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 50382 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation | 50384 | MPFS Status: Active Code APC Q2 ASC G2 Physician Quality Reporting CPT Assistant Article Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation | 50385 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting PUB 100 CPT Assistant Article Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation | 50386 | MPFS Status: Active Code APC Q2 ASC P3 Physician Quality Reporting PUB 100 CPT Assistant Article Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation | 50387 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation | 50389 | MPFS Status: Active Code APC Q2 ASC G2 Physician Quality Reporting CPT Assistant Article Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) | 50430 | Resequenced Code MPFS Status: Active Code APC Q2 ASC N1 Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access | 50431 | Resequenced Code MPFS Status: Active Code APC Q2 ASC N1 Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access | 50432 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation | 50433 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access | 50434 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract | 50435 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation | 50684 | MPFS Status: Active Code APC N ASC N1 Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter | 50688 | MPFS Status: Active Code APC J1 ASC A2 Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit | 50690 | MPFS Status: Active Code APC N ASC N1 Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service | 50693 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract | 50694 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter | 50695 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter | 51610 | MPFS Status: Active Code APC N ASC N1 Injection procedure for retrograde urethrocystography |
| LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SG | Ambulatory surgical center (asc) facility service | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2016-01-01 | Added | Added |