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Official Description

Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Cystourethroscopy is a medical procedure that allows healthcare professionals to visualize the interior of the bladder and urethra. This is achieved through the use of a cystoscope, which can be either rigid or flexible, and is inserted through the urethra into the bladder. Prior to the procedure, the urethra is typically cleansed with an antiseptic solution to minimize the risk of infection. During the cystourethroscopy, the bladder may be filled with sterile saline, enhancing the visibility of the bladder wall and any potential abnormalities. The procedure described by CPT® Code 52005 specifically involves the catheterization of the ureters, which are the tubes that carry urine from the kidneys to the bladder. After inspecting the bladder, a guidewire is introduced through the cystoscope and advanced into the first ureter, reaching the renal pelvis. A catheter is then advanced over this guidewire into the renal pelvis, allowing for further diagnostic or therapeutic interventions. The ureter may be irrigated with normal saline, or other diagnostic solutions may be instilled. Additionally, contrast material can be injected for ureteropyelography, which is a separate reportable service. This procedure can also be performed on the opposite ureter if necessary. At the conclusion of the procedure, both the catheter and guidewire are removed, completing the cystourethroscopy with ureteral catheterization.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 52005 is indicated for various clinical scenarios where visualization and intervention within the bladder and ureters are necessary. The following conditions may warrant the performance of cystourethroscopy with ureteral catheterization:

  • Urinary Tract Obstruction - This procedure may be performed to identify and address blockages in the urinary tract that could impede the flow of urine.
  • Ureteral Stones - Cystourethroscopy can be utilized to locate and potentially treat stones located in the ureters.
  • Bladder Tumors - The procedure allows for the visualization and assessment of tumors within the bladder, facilitating further diagnostic or therapeutic actions.
  • Hematuria - In cases of blood in the urine, cystourethroscopy can help determine the source of bleeding.
  • Urinary Tract Infections - Recurrent infections may necessitate this procedure to evaluate the urinary tract for underlying issues.

2. Procedure

The procedure for CPT® Code 52005 involves several key steps that ensure effective visualization and intervention within the urinary tract. The following outlines the procedural steps:

  • Step 1: Preparation - The patient is positioned appropriately, and the urethra is cleansed with an antiseptic solution to reduce the risk of infection. This preparation is crucial for maintaining a sterile environment during the procedure.
  • Step 2: Introduction of the Cystoscope - A rigid or flexible cystoscope is carefully introduced through the urethra into the bladder. This instrument is designed to provide a clear view of the bladder's interior.
  • Step 3: Filling the Bladder - Sterile saline may be instilled into the bladder to enhance visualization of the bladder wall and any potential abnormalities that may be present.
  • Step 4: Catheterization of the Ureters - Following the inspection of the bladder, a guidewire is introduced through the cystoscope and advanced into the first ureter, reaching the renal pelvis. This step is critical for accessing the ureters.
  • Step 5: Advancement of the Catheter - A catheter is then advanced over the guidewire into the renal pelvis, allowing for further diagnostic or therapeutic interventions.
  • Step 6: Irrigation and Instillation - The ureter may be irrigated with normal saline, or diagnostic or therapeutic solutions may be instilled as needed for further evaluation or treatment.
  • Step 7: Ureteropyelography - If indicated, contrast material may be injected to perform ureteropyelography, which is a separate reportable service that provides imaging of the urinary tract.
  • Step 8: Completion - The procedure may be repeated on the opposite ureter if necessary. Upon completion, both the catheter and guidewire are removed, concluding the cystourethroscopy with ureteral catheterization.

3. Post-Procedure

After the completion of the cystourethroscopy with ureteral catheterization, patients may be monitored for any immediate complications or adverse effects. It is common for patients to experience some discomfort or a burning sensation during urination following the procedure. Healthcare providers may offer guidance on managing these symptoms. Patients are typically advised to increase fluid intake to help flush the urinary tract and reduce the risk of infection. Follow-up appointments may be scheduled to discuss findings from the procedure and any necessary further interventions or treatments based on the results obtained during cystourethroscopy.

Short Descr CYSTO W/URTRL CATHJ
Medium Descr CYSTOURETHROSCOPY W/URETERAL CATHETERIZATION
Long Descr Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic 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.
Endoscopic Base Code 52000  Cystourethroscopy (separate 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) P8E - Endoscopy - cystoscopy
MUE 1
CCS Clinical Classification 102 - Ureteral catheterization
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).
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
CR Catastrophe/disaster related
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.
32 Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure.
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).
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).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
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.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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).
99 Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
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
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
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
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
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2011-01-01 Changed Medium description changed.
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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