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Official Description

Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A cystourethroscopy with the insertion of a permanent adjustable transprostatic implant is a minimally invasive procedure designed to alleviate urinary symptoms caused by benign prostatic hypertrophy (BPH). This condition often leads to the enlargement of the prostate, which can obstruct the urethra and result in difficulties with urination. The procedure involves the use of a rigid cystoscope, which is a thin tube equipped with a camera and light, allowing the physician to visualize the urethra and prostate. During the procedure, the surgeon inserts the implant through the cystoscope to effectively retract the obstructing lateral lobes of the prostate, thereby expanding the urethral lumen. This expansion helps to relieve lower urinary tract symptoms, such as increased frequency of urination, urgency, and weak urine flow. The adjustable nature of the implant allows for modifications post-insertion, ensuring optimal positioning and effectiveness in managing the symptoms associated with BPH. The procedure is typically performed on an outpatient basis, providing patients with rapid relief and a quick recovery time.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for patients experiencing lower urinary symptoms due to benign prostatic hypertrophy (BPH). These symptoms may include:

  • Increased Urinary Frequency The need to urinate more often than usual, particularly during the night.
  • Urgency A sudden, strong need to urinate that may be difficult to control.
  • Weak Urine Flow A decrease in the strength of the urine stream, making it difficult to fully empty the bladder.
  • Straining to Urinate Difficulty initiating urination or the need to push to begin the flow of urine.
  • Incomplete Bladder Emptying The sensation of not fully emptying the bladder after urination.

2. Procedure

The procedure involves several key steps to ensure the successful insertion of the permanent adjustable transprostatic implant:

  • Step 1: Preparation The patient is positioned appropriately, and local anesthesia may be administered to minimize discomfort during the procedure. The area is then sterilized to reduce the risk of infection.
  • Step 2: Cystoscope Insertion A rigid cystoscope is carefully inserted into the urethra. This instrument allows the physician to visualize the internal structures of the urinary tract, including the prostate.
  • Step 3: Implant Delivery Device Advancement Once the cystoscope is in place, the implant delivery device is advanced through the cystoscope. The device is angled anterolaterally to target the obstructive lobe of the prostate.
  • Step 4: Deployment of the Needle A needle, which is preloaded with a monofilament and a metallic tab, is deployed through the obstructive prostate lobe. The needle is then retracted, leaving the metallic tab engaged within the prostate tissue.
  • Step 5: Implant Attachment The urethral end-piece of the implant is attached to the tensioned monofilament. The monofilament is then cut, allowing the urethral end-piece to invaginate into the urethral wall.
  • Step 6: Epithelialization The invagination causes focal injury to the urethral wall, which will undergo a healing process known as epithelialization, ultimately securing the implant in place.

3. Post-Procedure

After the procedure, patients may experience some discomfort, which can typically be managed with over-the-counter pain relief. It is common for patients to be monitored for a short period before being discharged. Follow-up appointments are essential to assess the effectiveness of the implant and to make any necessary adjustments. Patients are advised to avoid strenuous activities and heavy lifting for a specified period to ensure proper healing. Additionally, they should report any unusual symptoms, such as severe pain, bleeding, or signs of infection, to their healthcare provider promptly.

Short Descr CYSTOURETHRO W/ADDL IMPLANT
Medium Descr CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL
Long Descr Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (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) 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 Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8E - Endoscopy - cystoscopy
MUE 6

This is an add-on code that must be used in conjunction with one of these primary codes.

52441 MPFS Status: Active Code APC B Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant
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
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.
RT Right side (used to identify procedures performed on the right side of the body)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
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.
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).
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.
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).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
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2015-01-01 Added Added
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