Procedure Performed for CPT code 50080 & 50081

The physician creates a percutaneous passageway to remove kidney stones (calculi). The physician makes a small incision in the skin of the back, inserts a large needle, and radiologically guides it toward the kidney or renal pelvis. After passing a guidewire through the needle, the physician dilates the passageway by inserting and removing tubes with increasingly larger diameters. The physician inserts an endoscope over the guidewire and passes an instrument through the endoscope to crush or extract calculi. The physician may pass a ureteral stent from the pelvis into the bladder. The physician removes the guidewire and allows the passageway to seal on its own, or inserts a nephrostomy or pyelostomy tube before removing the guidewire. CPT code 50080 is used for removal of calculi measuring up to 2 cm and CPT code 50081 for removal of calculi measuring more than 2 cm.

Read also: Coding guide for Antegrade Nephrostogram CPT code

Description of CPT code 50080, 50081, 50436 & 50437

For dilation, a guide is inserted into the renal pelvis and/or ureter to enlarge the passageway between the skin and kidney. The physician makes a small incision in the skin of the back, inserts a large needle, and ultrasonographically guides it toward the kidney. After passing a guidewire through the needle and through the kidney into the renal pelvis, the physician removes the needle by passing it backward over the guidewire. The physician enlarges (dilates) the guidewire passageway by inserting and removing tubes with increasingly larger diameters. When the passageway is sufficiently dilated, the physician passes a nephrostomy tube over the guidewire, removes the guidewire, and sutures the tube to the skin. All imaging, including radiologic supervision and interpretation, is included and should not be reported separately.

CPT code 50436 is used when the physician enlarges an existing percutaneous nephrostomy tract and inserts a needle into the renal collecting system in order to allow for the introduction of large instruments to be utilized in an endoscopic urologic procedure. CPT code 50437 is used when the physician creates new access into the renal collecting system in the same operative session where an existing tract is not present.

50080 Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm

50081 Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm

50436 Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed;

50437 Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting system

Do and Don’t with CPT code 50080, 50081, 50436 & 5043

Codes 50436 and 50437 include all imaging and hence do not report injection procedure code for antegrade nephrostogram 50430 & 50431 along with them.

CPT code 50436 and 50437 include post procedure placement of a nephrostomy tube. Do not report code 50432 or 50433 with these codes.