🩺 CPT Code 51702: Documentation & Billing Guide

Catheterization, Ureteral, Non-Endoscopic (Retrograde)

Last Updated: February 2026
Status: 2025 Medicare Fee Schedule Compliant
Specialty Tags: urology endoscopy diagnostic ureteral urology

QUICK REFERENCE

Element	Details
Code	51702
Code Type	Non-Endoscopic Catheterization Procedure
Procedure Type	Transurethral, retrograde ureteral catheterization (non-scope)
Global Period	000 days (office/outpatient procedure, no bundled post-op)
Work RVU (2025)	0.47 RVU
Practice Expense RVU (2025, Non-Facility)	0.39 RVU
Practice Expense RVU (2025, Facility)	0.16 RVU
Malpractice RVU (2025)	0.04 RVU
Total RVU (2025, Non-Facility)	0.90 RVU
Total RVU (2025, Facility)	0.67 RVU
2025 Medicare Fee (Non-Facility)	~ $29.11 (0.90 R V U \times$ 32.3465 CF × GPCI)
2025 Medicare Fee (Facility)	~ $21.67 (0.67 R V U \times$ 32.3465 CF × GPCI)
Conversion Factor (2025)	$32.3465
Estimated Commercial Insurance	$80 - 200
Common Place of Service	Office (11), Hospital outpatient (22), ASC, ED (23)
Specialty	Urology, Urogynecology, General Surgery, Emergency Medicine
Bundling Status	Often bundled with cystoscopy (52000) or other endoscopic procedures

📋 SHORT DEFINITION

CPT 51702 describes a non-endoscopic retrograde catheterization of the ureter, a procedure in which a catheter is passed through the urethra and bladder (without cystoscope/endoscopic visualization) to access and catheterize the ureter for diagnostic or therapeutic purposes such as ureteral obstruction relief, stent placement, or ureteral specimen collection.

LONG DEFINITION

CPT 51702 represents a catheterization of the ureter using a blind retrograde (non-endoscopic) approach. Unlike endoscopic ureteral catheterization (which uses a cystoscope for visualization), this procedure is performed without direct visualization using either:

Caution

51701, 51702, 51703: These are often bundled and not separately billable when performed as part of a larger surgical procedure (like a Cystourethroscopy)

Blind passage: Catheter passed through urethra and bladder into ureter based on anatomic landmarks (often under fluoroscopy guidance)
Palpation-guided: Provider may use digital palpation or fluoroscopic guidance to direct catheter

Common Clinical Indications:

Retrograde relief of ureteral obstruction (stone, stricture, mass)
Retrograde ureteral stent placement
Retrograde ureteral catheterization for diagnostic imaging (retrograde pyelography)
Ureteral specimen collection (brushings, washings for cytology)
Ureteral perfusion or medication administration
Diagnostic evaluation of ureteral patency
Relief of Obstructive uropathy when endoscopic approach not feasible/available

Procedure Details:

Typically performed in office, OR, ED, or outpatient setting
May be performed with or without anesthesia (sedation common)
Usually performed under fluoroscopic guidance (X-ray) for accuracy
Time: 10-30 minutes depending on difficulty
Can be diagnostic ONLY or therapeutic (e.g., stent placement, obstruction relief)

Key Distinctions:

CPT 51702 (non-endoscopic catheterization) = Blind retrograde approach, often using fluoroscopy
CPT 52005 (endoscopic ureteral catheterization) = Cystoscopic approach with direct visualization
CPT 50382-50387 (percutaneous catheterization) = Direct renal/ureteral access via flank puncture (different approach)

Important Note:

CPT 51702 is often bundled with cystoscopy (52000) and/or other endoscopic procedures when performed during the same session. Verify payer bundling rules before billing separately.

WORK RELATIVE VALUE UNITS (wRVUs) & COMPONENTS

Work RVU Breakdown (2025)

RVU Component	Value	What It Represents
Work RVU	0.47	Physician work and cognitive effort
Practice Expense RVU (non-facility)	0.39	Catheter, sterile equipment, fluoroscopy, staff time
Practice Expense RVU (facility)	0.16	Lower due to hospital/ASC equipment overhead
Malpractice RVU	0.04	Malpractice insurance and liability
TOTAL RVU (non-facility)	0.90	Total relative value units
TOTAL RVU (facility)	0.67	Total relative value units (lower)

RVU Conversion to Dollar Amount (2025)

Formula: RVU × Conversion Factor (CF) × Geographic Practice Cost Index (GPCI) = Payment

2025 Medicare Conversion Factor: $32.3465

Typical Calculations (Non-Facility, GPCI = 1.0):

0.47 wRVU × $32.3465 = * *$ 15.20** (work component)
0.39 PE RVU × $32.3465 = * *$ 12.62** (practice expense)
0.04 MP RVU × $32.3465 = * *$ 1.29** (malpractice)
Total = ~$29.11 per procedure (non-facility, GPCI 1.0)

Facility-Based (Hospital/ASC):

0.47 wRVU × $32.3465 = * *$ 15.20** (work component, same)
0.16 PE RVU × $32.3465 = * *$ 5.18** (practice expense, lower)
0.04 MP RVU × $32.3465 = * *$ 1.29** (malpractice, same)
Total = ~$21.67 per procedure (facility, GPCI 1.0)

Real-World Range (2025):

Non-Facility (Office): $27 -$ 33 (depending on GPCI)
Facility-Based (Hospital/ASC): $19 -$ 25 (lower PE RVU)

GLOBAL PERIOD

Global Period Status: 000 (Zero-Day Global)

What This Means:

CPT 51702 is a procedure with NO global period
There are NO pre-operative or post-operative days bundled
The code includes only the procedure on the date of service
No global period modifiers (-54, -55, -56) are needed
Post-operative follow-up visits are separately billable

Billing Implications:

Patient follow-up for procedure results or complications = separate E/M code (99212-99215 established, 99201-99205 new)
Same-day E/M + 51702 can be billed together with modifier -25 (separate, identifiable E/M)
If bundled with cystoscopy (52000), do NOT bill separately (verify payer bundling)

DOCUMENTATION REQUIREMENTS FOR 51702

Minimum Documentation Components

Indication/History:

Chief Complaint: “Ureteral obstruction,” “hematuria,” “stone retrieval,” etc.
History of Present Illness: Onset, duration, imaging findings (CT, ultrasound), prior treatment
Relevant PMH: Prior ureteral obstruction, stones, strictures, malignancy
Imaging Results: CT/ultrasound findings supporting need for catheterization

Procedure Description:

Position: Lithotomy or supine
Anesthesia: Topical (urethral jelly), local anesthesia, sedation, or general; dose documented
Instrumentation: Type of [catheter] used (feeding tube, catheter type/size), presence of guide wire
Approach: Blind retrograde, fluoroscopic-guided, digital palpation
Fluoroscopy: Note if fluoroscopy used (for billing purposes and radiation dose documentation)
Bilateral vs. Unilateral: Which ureter(s) accessed

Findings/Results:

Ureteral Access: Successfully accessed; difficulty encountered
Obstruction Status: Obstruction identified; location (proximal, mid, distal ureter)
Obstruction Relief: Partial, complete, or unsuccessful relief achieved
Specimen Collection: If biopsy, brushings, or washings obtained
Catheter Placement: Catheter successfully placed; catheter position (distal ureter, renal pelvis)
Contrast Administration: If diagnostic imaging performed, findings noted
Complications: Perforation, bleeding, infection, other adverse events

Assessment/Impression:

Procedure Success: “Successfully performed,” “partially successful,” “unsuccessful”
Finding: “Right ureteral obstruction due to stone,” “Left ureteral stricture,” etc.
Outcome: Obstruction relieved, catheter placed, specimen obtained

Plan:

Catheter Management: catheter left in place or removed; duration if left in place
Stent Placement: If stent placed (note if separate code CPT 50688, 50690, etc.)
Follow-up: Return to clinic, imaging studies, urology follow-up, etc.
Imaging: If retrograde pyelography performed, radiographic findings documented

Fluoroscopy Documentation (if applicable):

Note use of fluoroscopy/X-ray guidance
Number of images obtained
Radiation dose (if available)
Radiologic report, if separate
Consider billing CPT 76000-76001 (fluoroscopy supervision and interpretation) if not included

BUNDLING RULES (CRITICAL)

⚠️ IMPORTANT: CPT 51702 is frequently bundled with cystoscopy (52000) and/or other endoscopic procedures.

Common Bundling Scenarios

Scenario	Bundling Status	Notes
51702 alone	Non-bundled	Standalone catheterization, no cystoscopy
51702 + 52000 (cystoscopy)	BUNDLED	Usually included in 52000 when performed together
51702 + 52204 (cystoscopy + fulguration)	BUNDLED	Usually included in the cystoscopy code
51702 + 52282 (cystoscopy + ureteroscopy)	BUNDLED/INCLUDED	May be included in ureteroscopy code
51702 + stent placement (50688/50690)	SEPARATE	Stent codes are separate; catheterization may still be bundled with cystoscopy if performed endoscopically

⚠️ WARNING:

Many payers bundle 51702 when performed with endoscopic cystoscopy (52000 series). If billing 51702 + endoscopic procedure same day, verify payer policy before billing both. You may need modifier -59 (distinct procedural service) to unbundle.

When 51702 Is Separately Billable

Standalone non-endoscopic catheterization - No cystoscope used, pure blind retrograde catheterization
Non-endoscopic catheterization without concurrent endoscopic procedure - E.g., office-based catheterization for diagnostic retrograde pyelography
When unbundled by payer - Some payers may allow separate billing with appropriate modifier (-59)

MODIFIERS COMMONLY USED WITH 51702

Modifier	Description	When to Use
-25	Significant, separately identifiable E/M	When billing E/M same day; apply to E/M, not 51702
-59	Distinct Procedural Service	When catheterization distinct from endoscopic procedure; verify payer policy
-RT/-LT	Right/Left	To specify right vs. left ureter (bilateral catheterizations may require two codes)
-50	Bilateral Procedure	If bilateral catheterizations; some payers require 51702-50
-52	Reduced Services	If procedure partially reduced or incomplete (e.g., unsuccessful catheterization)
-22	Increased Procedural Services	If unusually complex (e.g., stricture, difficult anatomy requiring extended time)
None (most common)	Standard billing	Routine catheterization

Note

Modifier -59 Usage (Critical for Bundling):

If billing 51702 with endoscopic cystoscopy (52000 series), verify payer requires -59

Apply -59 to 51702 to indicate it’s a distinct procedure from the cystoscopy

Some payers will deny 51702 as bundled despite -59, so pre-authorization is recommended

MEDICARE RULES FOR 51702

CMS-Specific Rules & Policies

1. Bundling with Cystoscopy (52000)

Many Medicare Administrative Contractors (MACs) bundle 51702 when performed with cystoscopy (52000 series)
If performing non-endoscopic catheterization WITHOUT cystoscopy, 51702 is separately billable
Verify your MAC’s bundling policy in their LCD

2. Bundling with Ureteroscopy (52351-52352)

Retrograde ureteral catheterization performed during ureteroscopy may be included in the ureteroscopy code
If separate ureteral catheterization outside of ureteroscopy, may be separately billable

3. Fluoroscopy Billing

If fluoroscopy used for guidance, verify whether fluoroscopy is included in 51702 RVU or billed separately
CPT 76000-76001 (fluoroscopy supervision and interpretation) may be separately billable
Check payer policy; many include fluoroscopy in procedure RVU

4. Same-Day E/M Billing

Can bill E/M with modifier -25 on same day as 51702
E/M must be separately identifiable (not routine to procedure)
Example: 99213-25 (E/M for hematuria) + 51702 (ureteral catheterization)

5. Stent Placement Coding

If stent placed during catheterization, use additional code:
- CPT 50688 (ureteral stent placement, transurethral)
- CPT 50690 (ureteral stent placement, percutaneous)
Do NOT use 51702 + stent code if endoscopic approach used; use ureteroscopy code instead

6. RHC/FQHC Considerations

RHCs/FQHCs may bill 51702 but payment goes to facility’s all-inclusive rate
Individual provider cannot bill separately if employed by RHC/FQHC

LOCAL COVERAGE DETERMINATIONS (LCDs) & NATIONAL COVERAGE

National Coverage Determination (NCD)

There is NO specific NCD for CPT 51702.

General Medicare Coverage Policy:

Catheterization of ureters for relief of obstruction or diagnostic purposes covered when medically necessary
Must be appropriate based on patient’s presenting condition and imaging findings
No frequency limitations per Medicare statute (must be medically necessary)

Local Coverage Determinations (LCDs) - MAC-Specific

LCDs vary by Medicare Administrative Contractor (MAC) jurisdiction.

Common LCD Issues for 51702:

Requirement	Details
Bundling Status	Critical—many MACs bundle with cystoscopy (52000); verify before billing
Medical Necessity	Must have documented obstructive uropathy or diagnostic indication
Documentation	Procedure note must include findings (obstruction location, relief achieved, etc.)
Diagnosis Code	ICD-10 must support indication (N13.1 ureteral obstruction, N20 stone, etc.)
Fluoroscopy	Verify whether fluoroscopy is included or separately billable
Stent Coding	If stent placed, use appropriate stent code (50688 or 50690) in addition
Provider Credentials	Urologist or licensed provider with appropriate credentials

To Find Your MAC’s LCD:

Go to CMS LCD Search Tool: https://www.cms.gov/cclc/lcd
Enter your MAC jurisdiction
Search for “ureteral catheterization” or “retrograde catheterization”
Review bundling rules and coverage requirements

COMMON MODIFIERS & BILLING RULES

Modifier -25 (Distinct Procedural Service - With E/M)

Use when: Billing catheterization (51702) on same day as E/M code

Apply -25 to the E/M code (not 51702)

Example:

Patient presents with hematuria and flank pain (99213 = E/M)
Imaging shows ureteral obstruction
Provider performs retrograde ureteral catheterization (51702)
Billing: 99213 -25 + 51702

Modifier -59 (Distinct Procedural Service)

Use when: Billing catheterization (51702) with endoscopic procedure (52000 series) to indicate they are distinct

May be required by some payers; verify MAC policy

Example:

Patient undergoes cystoscopy (52000) for hematuria evaluation
During procedure, retrograde ureteral catheterization (51702) also performed
Billing: 52000 + 51702 -59 (if payer requires -59 to unbundle)
Warning: Some payers will still deny 51702 despite -59; pre-authorization recommended

Modifier -LT/-RT (Side-Specific)

Use when: Unilateral catheterization; specify right or left ureter

Billing examples:

Right ureteral catheterization: 51702-RT
Left ureteral catheterization: 51702-LT
Bilateral (separate codes): 51702-RT + 51702-LT (or 51702-50 if payer allows bilateral modifier)

Modifier -50 (Bilateral Procedure)

Some payers allow -50 for bilateral catheterizations; others require two separate codes (-RT and -LT)

Verify payer policy:

Some require: 51702-50 (bilateral)
Others require: 51702-RT + 51702-LT (each side separately)
Check your payer’s guidelines

2025 REIMBURSEMENT INFORMATION

Medicare 2025 Fee Schedule

CPT 51702 - Catheterization, Ureteral, Non-Endoscopic

Category	Value
Work RVU	0.47
Practice Expense RVU (non-facility)	0.39
Practice Expense RVU (facility)	0.16
Malpractice RVU	0.04
Total RVU (non-facility)	0.90
Total RVU (facility)	0.67
Conversion Factor (2025)	$32.3465
National Average Fee (Non-Facility, GPCI 1.0)	$29.11
Estimated Range (Non-Facility)	$27 - 33
National Average Fee (Facility, GPCI 1.0)	$21.67
Estimated Range (Facility)	$19 - 25

Year-Over-Year Comparison (2024 vs 2025)

Metric	2024	2025	Change
Work RVU	0.47	0.47	—
PE RVU (non-facility)	0.39	0.39	—
CF	$33.2875	$32.3465	-2.8%
National Average (Non-Facility)	~$29.99	~$29.11	-2.8%
Status	Active	Active	Unchanged

Reason for fee decrease: 2.8% conversion factor reduction due to expiration of temporary 2024 increase.

Commercial Insurance & Medicaid Reimbursement (2025)

Commercial Insurance:

Typically pays 2-4× Medicare rates
Estimated 51702 payment: $80 -$ 200 (varies by payer)
Often bundled with cystoscopy; may not allow separate payment

Medicaid:

Varies significantly by state
Estimated 51702 payment: $15 -$ 60 (state-dependent)
Many states pay only 50-70% of Medicare rate
Some states don’t cover separately (bundled with other procedures)

Self-Pay/Cash Price:

Typically $50 -$ 150 depending on provider and setting

Ureteral Catheterization Code Family

Code	Description	RVU	Approach	Use Case
51702	Catheterization, ureteral, non-endoscopic (retrograde)	0.47 work	Blind retrograde	Relief of obstruction, diagnostic retrograde pyelography
52005	cystourethroscopy with ureteral catheterization	0.67 work	Endoscopic (with cystoscope)	Visualization + catheterization for obstruction relief
50382	Percutaneous ureteral catheterization	1.04 work	Percutaneous (flank)	Direct renal access; alternative to retrograde approach
50688	Ureteral stent placement, transurethral	0.70 work	Endoscopic retrograde	Stent placement (additional code)
50690	Ureteral stent placement, percutaneous	0.88 work	Percutaneous	Stent placement via percutaneous approach

51702 vs 52005 (Catheterization Approaches)

Aspect	51702 (Non-Endoscopic)	52005 (Endoscopic)
Visualization	Blind retrograde or fluoroscopic guidance	Direct visualization with cystoscope
Approach	Transurethral, no scope	Transurethral, with scope (52000 included)
RVU (Work)	0.47	0.67
Bundling	Often bundled with 52000 if same session	Includes cystoscopy
Indication	Obstruction relief, diagnostic, when scope not needed	Direct visualization preferred, obstruction relief
Advantages	Simpler, no scope; can be office-based	Better visualization; direct assessment of bladder/urethra
Disadvantages	Blind approach; less visualization; may be bundled	Requires scope; more invasive

FREQUENTLY BILLED SCENARIOS FOR 51702

Scenario 1: Retrograde Relief of Ureteral Stone Obstruction

Patient: 54-year-old with right flank pain and CT-confirmed right ureteral stone
Imaging: CT shows right mid-ureteral stone with proximal hydronephrosis
Indication: Retrograde relief of ureteral stone obstruction
Procedure: Patient positioned supine, draped sterile. Retrograde ureteral catheterization performed under fluoroscopic guidance. Catheter advanced blindly through urethra, past ureteropelvic junction into right proximal ureter above stone. Contrast injected retrograde; stone confirmed at mid-ureter. Catheter left in place as ureteral stent for drainage and pain relief.
Findings: Right ureteral stone at mid-ureter confirmed on retrograde pyelography. Successful catheter placement above obstruction.
Plan: Catheter left in place. Patient to follow up with urology for definitive stone management ureteroscopy and stone extraction.
Coding:

51702 (ureteral catheterization, non-endoscopic)
50688 (ureteral stent placement, transurethral) - if stent left as separate billable service
76000 or 76001 (fluoroscopy) - if not bundled in 51702
Diagnosis: N20.1 (ureteral stone), N13.2 (hydronephrosis, secondary)

Scenario 2: Diagnostic Retrograde Pyelography for Ureteral Stricture

Patient: 68-year-old with history of prior pelvic surgery, now with recurrent UTI and left flank pain
Imaging: Ultrasound shows left hydronephrosis; stone ruled out
Indication: Diagnostic retrograde pyelography to assess for stricture
Procedure: Retrograde ureteral catheterization performed blindly using fluoroscopic guidance. Catheter advanced into left ureter. Contrast injected; stricture identified at distal left ureter post-pelvic surgery.
Findings: Left distal ureteral stricture confirmed on retrograde pyelography. No immediate intervention performed; patient counseled on options.
Plan: Refer to urology for endoscopic or percutaneous intervention. Possible stent placement or dilation.
Coding:

51702 (ureteral catheterization, non-endoscopic)
76000 or 76001 (fluoroscopy, if separate)
Diagnosis: N13.0 (ureteral stricture), N13.2 (hydronephrosis, secondary), Z12.81 (history of pelvic surgery)

Scenario 3: Retrograde Ureteral Catheterization with Specimen Collection

Patient: 72-year-old with hematuria and imaging suggesting ureteral mass
Imaging: CT shows possible ureteral lesion, left proximal ureter
Indication: Diagnostic catheterization with brushing/specimen collection for cytology
Procedure: Retrograde ureteral catheterization performed. Catheter advanced to left proximal ureter. Brush catheter passed through for brushing of lesion; specimens obtained for cytopathology.
Findings: Ureteral lesion visualized; brushings obtained. Cytology pending.
Plan: Await cytology results. If malignancy confirmed, refer for endourology or oncology consultation.
Coding:

51702 (ureteral catheterization, non-endoscopic)
52007 (cystourethroscopy with brush biopsy of ureteral/renal pelvis lesion) - if endoscopic approach used instead
Diagnosis: R31.9 (hematuria, unspecified), N13.1 (hydronephrosis with ureteral obstruction, unspecified)

Scenario 4: Retrograde Catheterization During Cystoscopy (Bundling Issue)

Patient: 58-year-old with gross hematuria and imaging showing bladder mass and right ureteral obstruction
Procedure: Cystoscopy performed for bladder evaluation. During cystoscopy, retrograde ureteral catheterization performed to relieve right ureteral obstruction due to extrinsic compression from bladder tumor.
Findings: Bladder tumor noted on cystoscopy. Right ureteral obstruction relieved with catheterization.
Plan: Ureteral stent placement. Oncology referral for bladder tumor.
Coding (Verify payer bundling):

52000 or 52204 (cystoscopy, with or without fulguration)
51702 - May be bundled with cystoscopy; verify if separately billable
- If separately billable: Add 51702-59 (distinct procedural service)
- If bundled: Do NOT bill 51702 separately
50688 (ureteral stent placement) - Separately billable
Diagnosis: C67.9 (bladder cancer), N13.1 (ureteral obstruction)
⚠️ WARNING: Pre-authorization recommended due to bundling uncertainty

DOCUMENTATION TIPS FOR 51702

What to Document

✓ SHOULD INCLUDE:

Procedure Indication - Obstruction relief, diagnostic imaging, specimen collection, etc.
Imaging Results - CT/ultrasound findings supporting need for catheterization
Patient Position - Lithotomy, supine, other
Anesthesia - Type (topical, local, sedation, general), dosage
Approach - Blind retrograde, fluoroscopic-guided, digital palpation
Instrumentation - Catheter type and size, guide wire use, number of attempts
Fluoroscopy - Note if used; document fluoroscopy time/dose if available
Bilateral vs. Unilateral - Which ureter(s) catheterized
Ureteral Access - Successfully accessed, attempts required, any difficulty
Obstruction Assessment:
- Location: Proximal, mid, or distal ureter
- Cause: stone, stricture, mass, clot, other
- Relief: Partial, complete, or unsuccessful obstruction relief
Catheter Placement: Final position, catheter left in place or removed
Specimen Collection: If obtained (brushings, washings, biopsy); note specimens sent
Contrast Administration: If retrograde pyelography performed; findings documented
Complications: Perforation, bleeding, infection, other adverse events
Post-Procedure Plan - Follow-up, stent management, definitive treatment planning
Provider Signature/Authentication - Date, time, credentials

✗ SHOULD AVOID:

Vague findings (“procedure successful” without detail on location or relief achieved)
Missing obstruction location or characteristics
No documentation of which ureter(s) catheterized (especially important for bilateral procedures)
Copy-paste from previous notes without updating for current procedure
Missing fluoroscopy documentation if performed
No assessment of whether obstruction was relieved

Sample Documentation Format

Procedure Note - Retrograde Ureteral Catheterization (51702)

INDICATION:
Patient presents with right flank pain and CT findings of right mid-ureteral stone with proximal hydronephrosis and elevated creatinine. Retrograde ureteral catheterization performed for relief of Obstructive uropathy.

PROCEDURE:
Patient placed in supine position and prepped and draped in sterile fashion. Digital rectal examination performed to assess prostate size and patency. Retrograde approach selected due to stone location. Retrograde ureteral catheterization performed under fluoroscopic guidance using a 7 Fr open-ended ureteral catheter. Catheter advanced blindly through urethra, past ureteropelvic junction into right proximal ureter. Contrast (30 mL Visipaque) injected retrograde for diagnostic imaging.

FINDINGS:

Obstruction Location: Right mid-ureteral stone, approximately 1.2 cm, confirmed on retrograde pyelography.

Catheter Placement: 7 Fr catheter successfully advanced to right proximal ureter, proximal to stone obstruction. Final catheter position: right proximal ureter at level of L2 vertebra.

Obstruction Relief: Complete relief of obstruction achieved. Retrograde flow of contrast into renal pelvis and calices; no hydronephrosis noted on immediate post-catheterization images. Catheter patent with free flow of urine/contrast.

Fluoroscopy: Fluoroscopic guidance used throughout procedure. Approximately 8 fluoroscopic images obtained. Estimated radiation dose: 0.5 mGy.

Complications: None.

ASSESSMENT:
Successful retrograde ureteral catheterization with relief of right ureteral stone obstruction.

PLAN:

Ureteral catheter left in place as temporary stent for pain relief and drainage.
Patient discharged with catheter. Leg bag provided for drainage management at home.
Patient counseled on signs of infection (fever, dysuria, purulent drainage) and instructed to return immediately if fever or severe pain develops.
Follow-up appointment in 1 week with urology for definitive stone management (ureteroscopy and laser lithotripsy vs. percutaneous approach).
Stent removal/replacement plan: Stent to remain in place for 1 week, then reassessed after stone treatment.

AUDIT DEFENSE CHECKLIST FOR 51702

Before billing 51702, verify:

RED FLAGS FOR AUDITORS

51702 claims are at audit risk if:

❌ Medical necessity documentation missing or vague (“catheterization for hematuria evaluation” without imaging)
❌ Obstruction location or characteristics not documented
❌ Bilateral procedures coded as unilateral without specification (-RT/-LT missing)
❌ Billed with cystoscopy (52000) without verification of bundling rules (payer may deny 51702)
❌ Fluoroscopy used but not documented; no fluoroscopy code billed (if separately billable)
❌ Catheter left in place but no stent code (50688/50690) billed when appropriate
❌ Procedure appears routine/incomplete but documented as successful
❌ E/M billed same day without -25 modifier (may be bundled/denied)
❌ Specimen collection documented but no collection code (52007 if endoscopic approach) billed
❌ Documentation appears copy-pasted or generic without specific procedure details

MEDICARE RULES & RESTRICTIONS

Who Can Bill 51702?

Qualified Providers:

MD/DO: Urologist, urogynecologist, general surgeon, internist, emergency medicine physician (with appropriate training)
NP: Nurse Practitioner with urology or relevant specialty training
PA: Physician Assistant in 00 Urology Specialty or with appropriate training
Other specialists: May perform depending on scope of practice and state regulations

Licensing & Credentialing: Verify state regulations and facility/payer credentialing requirements.

RHC/FQHC Restrictions

If provider is employed by RHC or FQHC:

51702 is reportable but payment goes to facility’s All-Inclusive Rate (AIR) or Prospective Payment System (PPS)
Individual provider cannot bill separately for 51702
Facility receives bundled payment for all services that day

Telehealth Coverage for 51702

CPT 51702 via Telehealth:

NOT reimbursable via telehealth because procedure requires direct patient contact and requires physical manipulation of catheter through urethra
Telehealth consultations about catheterization results or planning = E/M code (99213, 99214, etc.), not 51702

Concurrent Billing Issues

Same-Day Billing with E/M:

Can bill 51702 + E/M same day with modifier -25 on the E/M code
E/M must be separately identifiable (not routine to procedure)
Example: 99213-25 (E/M for hematuria) + 51702 (ureteral catheterization)

Same-Day Billing with Cystoscopy (52000):

OFTEN BUNDLED - Verify payer policy before billing both
If bundled: Do NOT bill 51702 separately
If separately billable: Bill 51702-59 to indicate distinct procedural service
Pre-authorization recommended due to bundling variability

COMPLIANCE & CODING EXAMPLES

Appropriate 51702 Use Cases ✓

Retrograde relief of ureteral stone obstruction - Stone causing obstruction and pain; catheterization for relief
Retrograde relief of ureteral stricture obstruction - Stricture causing hydronephrosis; catheterization for diagnostic imaging and relief
Diagnostic retrograde pyelography - Evaluation of hematuria with possible ureteral pathology
Specimen collection - Brushing, washing for cytology in suspected ureteral malignancy
Retrograde ureteral catheterization for medication administration - Therapeutic intervention
Retrograde catheterization to assess ureteral patency - Pre-operative evaluation
Non-endoscopic catheterization for diagnostic purposes - When endoscopic approach not feasible

Inappropriate 51702 Use (Risks) ✗

❌ Billed with endoscopic cystoscopy without verification of bundling - May be bundled; payer may deny
❌ Billed for bilateral obstruction without bilateral modifier - 51702-LT and 51702-RT (or 51702-50) required
❌ Medical necessity documentation missing - No imaging or clinical justification documented
❌ Used instead of endoscopic catheterization (52005) without clear indication - Non-endoscopic approach should have justification
❌ Billed without stent code when stent placed - If stent placed, add 50688 or 50690

FREQUENTLY ASKED QUESTIONS (FAQs)

Q: When should I use 51702 instead of 52005 (endoscopic catheterization)?
A: 51702 is non-endoscopic (blind retrograde), useful when cystoscope not needed or not available. 52005 is endoscopic with cystoscopy. 52005 is preferred if direct visualization needed; 51702 is simpler but blind approach.

Q: Can I bill 51702 if I perform it during cystoscopy?
A: Typically NO. If catheterization performed during cystoscopy (with cystoscope), use 52005 or include in cystoscopy code (52000 series). 51702 is specifically for non-endoscopic approach. Verify payer bundling rules.

Q: Should I bill 51702 and 52005 for the same patient if I use both approaches (first blind, then endoscopic)?
A: Possibly, if clearly documented as two separate attempts with clinical justification. However, most payers would likely deny 51702 as bundled with 52005. Pre-authorization recommended.

Q: Can I bill 51702 if I place a ureteral stent?
A: Yes. 51702 is catheterization; 50688 or 50690 is stent placement. They are separate codes and can both be billed if both services performed.

Q: Is fluoroscopy included in 51702 reimbursement?
A: Partially. The 51702 RVU assumes some fluoroscopy guidance, but additional fluoroscopy (76000-76001 supervision and interpretation) may be separately billable. Verify payer policy.

Q: What if my retrograde catheterization attempt fails?
A: Document the attempt and failure reason. If procedure not completed, use modifier -52 (reduced services). Payer may pay reduced RVU amount.

Q: Can I bill 51702 for both right and left ureter in one procedure?
A: Yes. Use modifier -50 (bilateral) or bill two separate codes 51702-LT and 51702-RT. Check your payer’s preference; some require bilateral modifier, others require separate side-specific codes.

Q: Is 51702 bundled with routine cystoscopy (52000)?
A: Often YES. Many MACs bundle 51702 with 52000 when performed together. Some allow separate billing with modifier -59. Verify your MAC’s LCD before billing both.

REAL-WORLD BILLING TIPS

Tips to Maximize Compliance & Revenue

Verify bundling rules FIRST - Check MAC LCD and payer policy before billing 51702 with cystoscopy
Document obstruction specifics - Location (proximal/mid/distal), cause (stone/stricture/mass), relief achieved
Use bilateral modifiers correctly - 51702-50 or 51702-LT + 51702-RT (verify payer preference)
Link diagnosis to indication - ICD-10 codes should match catheterization reason
Document imaging results - CT/ultrasound findings supporting need for catheterization
Include fluoroscopy documentation - Note fluoroscopy use; verify if separately billable
Use -25 with E/M same day - When E/M billed with 51702, apply -25 to E/M
Pre-authorize bundling uncertainty - If billing 51702 + 52000, request pre-auth to avoid denial
Document specimen collection separately - If biopsy/brushings obtained, note collection method and specimens obtained
Keep procedure notes detailed - Specify catheter size, route, obstruction location, catheter placement, relief achieved

BILLING & CODING RESOURCES

Recommended Resources:

AMA CPT Manual 2025 - Official CPT code definitions
CMS Fee Schedule Database: https://www.cms.gov/medicare/physician-fee-schedule
MAC LCDs: https://www.cms.gov/cclc/lcd (search for “ureteral catheterization”)
American Urological Association (AUA): https://www.auanet.org (coding resources)
Your payer’s provider manual - Payer-specific bundling rules

SUMMARY TABLE

Element	Details
Official Definition	Catheterization, ureteral, non-endoscopic (retrograde)
Global Period	000 (no bundled post-op)
Work RVU (2025)	0.47
Total RVU (2025, Non-Facility)	0.90
Medicare Payment (2025, Non-Facility)	~$29.11
Medicare Payment (2025, Facility)	~$21.67
Typical Time	10-30 minutes
Provider Required	Yes (urologist, surgeon, or trained provider)
Common Modifiers	-LT/-RT (side-specific), -25 (with E/M), -59 (distinct from endoscopy), -50 (bilateral)
Typical Use	Obstruction relief, diagnostic imaging, specimen collection
Common Mistakes	Bundling with cystoscopy without verification; missing bilateral modifiers; inadequate documentation
Audit Risk	Moderate (bundling is main risk)
Bundling	Often bundled with cystoscopy (52000); verify payer policy
Telehealth Allowed	No (requires direct patient contact)

Document Created: February 2026
Compliant with: 2021 AMA E/M Guidelines, 2025 Medicare Physician Fee Schedule, CMS NCCI Coding Policy Manual, Current Payer Policies
Last Updated: February 2026

Explorer

51702

🩺 CPT Code 51702: Documentation & Billing Guide

Catheterization, Ureteral, Non-Endoscopic (Retrograde)

QUICK REFERENCE

📋 SHORT DEFINITION

LONG DEFINITION

WORK RELATIVE VALUE UNITS (wRVUs) & COMPONENTS

Work RVU Breakdown (2025)

RVU Conversion to Dollar Amount (2025)

GLOBAL PERIOD

DOCUMENTATION REQUIREMENTS FOR 51702

Minimum Documentation Components

BUNDLING RULES (CRITICAL)

Common Bundling Scenarios

When 51702 Is Separately Billable

MODIFIERS COMMONLY USED WITH 51702

MEDICARE RULES FOR 51702

CMS-Specific Rules & Policies

LOCAL COVERAGE DETERMINATIONS (LCDs) & NATIONAL COVERAGE

National Coverage Determination (NCD)

Local Coverage Determinations (LCDs) - MAC-Specific

COMMON MODIFIERS & BILLING RULES

Modifier -25 (Distinct Procedural Service - With E/M)

Modifier -59 (Distinct Procedural Service)

Modifier -LT/-RT (Side-Specific)

Modifier -50 (Bilateral Procedure)

2025 REIMBURSEMENT INFORMATION

Medicare 2025 Fee Schedule

Year-Over-Year Comparison (2024 vs 2025)

Commercial Insurance & Medicaid Reimbursement (2025)

COMPARISON TO RELATED CODES

Ureteral Catheterization Code Family

51702 vs 52005 (Catheterization Approaches)

FREQUENTLY BILLED SCENARIOS FOR 51702

Scenario 1: Retrograde Relief of Ureteral Stone Obstruction

Scenario 2: Diagnostic Retrograde Pyelography for Ureteral Stricture

Scenario 3: Retrograde Ureteral Catheterization with Specimen Collection

Scenario 4: Retrograde Catheterization During Cystoscopy (Bundling Issue)

DOCUMENTATION TIPS FOR 51702

What to Document

Sample Documentation Format

AUDIT DEFENSE CHECKLIST FOR 51702

RED FLAGS FOR AUDITORS

MEDICARE RULES & RESTRICTIONS

Who Can Bill 51702?

RHC/FQHC Restrictions

Telehealth Coverage for 51702

Concurrent Billing Issues

COMPLIANCE & CODING EXAMPLES

Appropriate 51702 Use Cases ✓

Inappropriate 51702 Use (Risks) ✗

FREQUENTLY ASKED QUESTIONS (FAQs)

REAL-WORLD BILLING TIPS

Tips to Maximize Compliance & Revenue

BILLING & CODING RESOURCES

SUMMARY TABLE

Graph View

Table of Contents

Recent Notes