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Official Description

Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 51020 involves a surgical intervention on the urinary bladder, specifically a cystotomy or cystostomy. In this context, a cystotomy refers to the surgical incision into the bladder, while a cystostomy indicates the creation of an opening into the bladder. The primary goal of this procedure is to access the internal lumen of the bladder for therapeutic purposes. This can be achieved through two methods: either by fully exposing and incising the bladder or by making a smaller incision over the bladder and puncturing the bladder wall to gain access. Once access is obtained, the procedure focuses on the destruction of abnormal tissue within the bladder. This is accomplished through two main techniques: fulguration, which involves the use of an electrocautery device to destroy the tissue by applying heat, or by inserting radioactive material directly into the lesion. The electrocautery device is carefully advanced to the site of the abnormal tissue, activated, and used to effectively destroy the lesion. Alternatively, a laser may be employed for the same purpose. In cases where radioactive material is utilized, a delivery device is inserted into the bladder and positioned precisely at the lesion site, allowing for the embedding of a radioactive pellet into the mucosa or bladder wall to treat the abnormal tissue. This procedure is significant in managing various bladder conditions, particularly those involving abnormal tissue growths or lesions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 51020 is indicated for the treatment of various conditions affecting the urinary bladder. The following are the explicitly provided indications for performing this procedure:

  • Abnormal Tissue Growths - The procedure is indicated for the destruction of abnormal tissue or lesions within the bladder that may be benign or malignant.
  • Bladder Tumors - It is performed in cases where tumors are present in the bladder, necessitating intervention to prevent further complications.
  • Bladder Lesions - The procedure is suitable for addressing lesions that require targeted treatment to mitigate symptoms or prevent progression.

2. Procedure

The procedural steps for CPT® Code 51020 are as follows:

  • Step 1: Accessing the Bladder - The procedure begins with the exposure of the urinary bladder. This can be achieved through a full incision (cystotomy) or by making a smaller incision over the bladder and puncturing the bladder wall (cystostomy) to gain access to the internal lumen.
  • Step 2: Identifying the Abnormal Tissue - Once access to the bladder is established, the surgeon identifies the site of the abnormal tissue or lesion that requires treatment.
  • Step 3: Fulguration or Insertion of Radioactive Material - The next step involves either the destruction of the abnormal tissue using an electrocautery device or the insertion of radioactive material. If fulguration is chosen, the electrocautery device is advanced to the lesion site, activated, and used to destroy the tissue through heat application. Alternatively, if radioactive material is utilized, a delivery device is inserted into the bladder and positioned at the lesion site, allowing for the embedding of a radioactive pellet into the mucosa or bladder wall.

3. Post-Procedure

After the completion of the procedure, post-operative care is essential to ensure proper recovery. Patients may be monitored for any immediate complications related to the surgical intervention. It is important to assess for signs of infection, bleeding, or any adverse reactions to the treatment. Patients may also require follow-up imaging or evaluations to determine the effectiveness of the procedure in addressing the abnormal tissue. Additionally, instructions regarding activity restrictions, hydration, and any prescribed medications should be provided to support the healing process and optimize recovery.

Short Descr CYSTOTOMY/CYSTOSTOMY W/FULG
Medium Descr CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
Long Descr Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 112 - Other OR therapeutic procedures of urinary tract
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).
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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GC This service has been performed in part by a resident under the direction of a teaching physician
Date
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Notes
2025-01-01 Changed Short and Long Descriptions changed.
Pre-1990 Added Code added.
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