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Official Description

Complex cystometrogram (ie, calibrated electronic equipment);

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A complex cystometrogram (CMG) is a specialized diagnostic procedure used to assess bladder function by measuring bladder capacity and storage pressures. This test is particularly valuable in evaluating various urological conditions, including urinary incontinence, difficulties with urination, and neurogenic bladder disorders. The procedure begins with the patient emptying their bladder, after which the volume of urine is measured. To ensure a sterile environment, the urethra is cleansed with an antiseptic solution. A sterile catheter equipped with a sensor is then carefully inserted through the urethra into the bladder. Once in place, the bladder is filled with sterile saline, and the physician engages the patient in a dialogue to gather information about the sensations experienced during the filling process, such as feelings of fullness, pain, urgency, and any instances of leakage. In the context of CPT® Code 51726, the complex CMG is conducted using calibrated electronic equipment that allows for the simultaneous measurement of intra-abdominal pressure, total bladder pressure, and true detrusor pressure. The detrusor refers to the muscular wall of the bladder, which plays a crucial role in bladder function. This advanced testing capability enables healthcare providers to differentiate between involuntary detrusor contractions and changes in bladder compliance that may occur due to increased intra-abdominal pressure. The complexity of this procedure is essential for accurate diagnosis and treatment planning in patients with bladder dysfunction.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The complex cystometrogram (CMG) is indicated for the evaluation of various urological conditions and symptoms, which include:

  • Urinary Incontinence - A condition characterized by the involuntary loss of urine, which can significantly impact a patient's quality of life.
  • Difficulty with Urination - This may involve issues such as hesitancy, straining, or incomplete bladder emptying, which can indicate underlying bladder dysfunction.
  • Neurogenic Bladder - A condition resulting from nerve damage that affects bladder control, often seen in patients with neurological disorders.

2. Procedure

The procedure for a complex cystometrogram involves several detailed steps to ensure accurate measurement and assessment of bladder function:

  • Step 1: Patient Preparation - The patient is instructed to empty their bladder completely before the procedure begins. This initial step is crucial for establishing a baseline measurement of bladder capacity.
  • Step 2: Urethral Cleansing - The urethra is cleansed with an antiseptic solution to minimize the risk of infection during the procedure.
  • Step 3: Catheter Insertion - A sterile catheter equipped with a sensor is carefully inserted through the urethra into the bladder. This catheter is essential for measuring pressures within the bladder.
  • Step 4: Bladder Filling - The bladder is filled with sterile saline solution. This filling process is monitored closely, as it allows for the assessment of bladder capacity and pressure responses.
  • Step 5: Patient Sensation Assessment - Throughout the filling process, the physician queries the patient regarding their sensations, including feelings of fullness, pain, urgency, and any leakage. This feedback is vital for interpreting the results.
  • Step 6: Pressure Measurement - Using calibrated electronic equipment, the procedure measures intra-abdominal pressure, total bladder pressure, and true detrusor pressure simultaneously. This comprehensive data collection is critical for accurate diagnosis.
  • Step 7: Interpretation and Reporting - After the completion of the complex CMG, the physician interprets the collected data and provides a detailed written report, which includes findings and recommendations for further management.

3. Post-Procedure

After the complex cystometrogram, patients may experience some temporary discomfort or a sensation of urgency as the bladder returns to its normal state. It is important for patients to be informed about potential post-procedure symptoms, which may include mild cramping or a burning sensation during urination. Patients are typically advised to drink plenty of fluids to help flush out the saline used during the procedure. Follow-up appointments may be scheduled to discuss the results of the CMG and to determine any necessary treatment options based on the findings. Additionally, patients should be monitored for any signs of infection or complications following the procedure.

Short Descr COMPLEX CYSTOMETROGRAM
Medium Descr BLADDER PRESSURE MEASUREMENT DURING FILLING
Long Descr Complex cystometrogram (ie, calibrated electronic equipment);
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
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) 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 Procedure or Service, Multiple Reduction Applies
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) P6C - Minor procedures - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 200 - Nonoperative urinary system measurements
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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.
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.)
AG Primary physician
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
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
GZ Item or service expected to be denied as not reasonable and necessary
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Date
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Notes
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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