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Official Description

Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 52327 involves cystourethroscopy, which is a minimally invasive diagnostic and therapeutic procedure used to examine the bladder and urethra. During this procedure, a cystourethroscope—a specialized instrument equipped with a camera and light—is inserted through the urethra and advanced into the bladder. This allows the physician to visualize the internal structures of the urinary tract. The procedure includes ureteral catheterization, which may be necessary to access the ureters, the tubes that carry urine from the kidneys to the bladder. A key component of this procedure is the subureteric injection of implant material, which is intended to elevate and narrow the ureteral orifice, thereby providing support to the ureter. This technique is commonly referred to as the subureteral transurethral injection (STING) procedure. An alternative method known as the hydrodistention-implantation technique (HIT) may also be utilized. The procedure typically involves the use of a catheter to drain urine from the bladder, and the bladder is partially filled with fluid to enhance visualization of the ureteral orifice. The physician may employ various techniques for ureteral catheterization, including the use of guidewires or a wireless technique, to ensure accurate placement of the catheter. Following the injection of the implant material, the physician verifies the correct placement before completing the procedure by emptying the bladder and withdrawing the cystourethroscope.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 52327 is indicated for the treatment of conditions related to the ureteral orifice, particularly in cases where there is a need to support the ureter and improve its function. The following conditions may warrant this procedure:

  • Ureteral Reflux - A condition where urine flows backward from the bladder into the ureters, which can lead to urinary tract infections and kidney damage.
  • Ureteral Obstruction - Blockage of the ureter that can cause pain, infection, or kidney damage.
  • Urinary Incontinence - Involuntary leakage of urine that may be associated with ureteral dysfunction.

2. Procedure

The procedure begins with the patient being positioned appropriately, and local or general anesthesia may be administered as needed. The physician then inserts a catheter to drain urine from the bladder. Following this, a cystourethroscope is introduced through the urethra and advanced into the bladder. The bladder is partially filled with fluid in a retrograde manner to enhance visualization of the ureteral orifice. Once the cystourethroscope is in place, the physician carefully advances the scope to the ureteral orifice.

  • Step 1: The bladder is filled with fluid to allow for better visualization of the ureteral orifice.
  • Step 2: The cystourethroscope is advanced to the ureteral orifice, where the ureter may be distended using a pressurized stream of irrigation fluid.
  • Step 3: If ureteral catheterization is necessary, the physician may employ a guidewire technique, which requires two guidewires. A safety guidewire is first passed into the ureter, followed by the insertion of a semirigid or flexible ureteroscope alongside the safety guidewire.
  • Step 4: A temporary ureteral catheter is then passed over the working guidewire and positioned within the ureter. Alternatively, a wireless or 'no touch' technique may be utilized for catheter placement.
  • Step 5: Once the ureter is catheterized, the ureteroscope is removed, and a needle is passed through the cystourethroscope into the submucosa located below the ureteral orifice.
  • Step 6: The physician injects the implant material to elevate and narrow the ureteral orifice, providing necessary support to the ureter.
  • Step 7: After the injection, the cystourethroscope is withdrawn to the level of the bladder neck to visualize the implant site and ensure proper placement of the implant material.
  • Step 8: Finally, the bladder is emptied, and the cystourethroscope is completely withdrawn from the urethra.

3. Post-Procedure

After the completion of the procedure, patients may be monitored for any immediate complications. It is common for patients to experience some discomfort or mild pain following the procedure, which can typically be managed with over-the-counter pain relief. Patients may also be advised to increase fluid intake to help flush the urinary system. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and monitor for any potential complications, such as infection or urinary retention. It is important for patients to report any unusual symptoms, such as fever, severe pain, or changes in urination, to their healthcare provider promptly.

Short Descr CYSTOSCOPY INJECT MATERIAL
Medium Descr CYSTO W/SUBURTRIC NJX IMPLT MATRL
Long Descr Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material
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) 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.
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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
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
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).
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.)
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)
GC This service has been performed in part by a resident under the direction of a teaching physician
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)
Date
Action
Notes
2011-01-01 Changed Short description changed.
1995-01-01 Added First appearance in code book in 1995.
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