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Coding for Urodynamic Procedures

Urodynamic testing is specialized testing of the bladder, urethra and pelvic floor function during urine
storage and micturition. The testing utilizes small pressure measuring catheters to assess bladder
(detrusor) pressure and compliance as well as urethral sphincter pressure and tone. Assessment of
levator muscle function during the storage and micturition phases can also be assessed.

Current CPT Codes for Reporting Urodynamic Procedures:

CPT code 51726 Complex cystometrogram (i.e., calibrated electronic equipment)

CPT code 51727 Complex cystometrogram; with urethral pressure profile studies (i.e., urethral
closure pressure profile), any technique

CPT code 51728 Complex cystometrogram; with voiding pressure studies (i.e., bladder voiding
pressure), any technique

CPT code 51729 Complex cystometrogram; with voiding pressure studies (i.e., bladder voiding
pressure) and urethral pressure profile studies (i.e., urethral closure pressure profile), any technique

CPT code +51797 Voiding pressure studies, intra-abdominal (i.e., rectal, gastric, intraperitoneal)
(List separately in addition to code for primary procedure)
(Use 51797 in conjunction with 51728 and 51729)
(CPT code 51772 has been deleted. To report urethral pressure profile studies, see 51727, 51729)
(CPT code 51795 has been deleted. To report bladder voiding pressure studies, see 51728, 51729)

Full urodynamic testing would result in reporting the following four CPT codes:
51741 for complex uroflowmetry
51729 for complex cystometrogram, including measurement of urethral pressure and bladder
voiding/flow pressure
51784 or 51785 for the EMG
+51797 for the abdominal pressure, whether measured rectally or vaginally

Last Updated by the AUGS Coding and Reimbursement Committee on January 2018

Disclaimer: The Coding and Reimbursement Committee of the American Urogynecologic Society (AUGS) assists members with the
application of governmental regulations and guidelines regarding terminology and CPT/ICD coding in urogynecologic practice. Such
information is intended to assist with the coding process as required by governmental regulation and should not be construed as
policy sanctioned by AUGS. AUGS disclaims liability for actions or consequences related to any of the information provided. AUGS
does not endorse the diagnostic protocol or treatment plan designed by the provider.
 1100 Wayne Ave, Suite 825
Silver Spring, MD 20910
301.273.0570 ▪ Fax 301.273.0778
info@[Link] ▪ [Link]

CPT codes and RVU table from 2018 National Physician Fee Schedule:

CPT Mod Description Total RVU Total RVU

Non-Facility Facility
51726 Complex Cystometrogram 7.59 NA
51726 TC Complex Cystometrogram 5.13 NA
51726 26 Complex Cystometrogram 2.46 2.46
51727 Cystometrogram with UPP 8.93 NA
51727 TC Cystometrogram with UPP 5.86 NA
51727 26 Cystometrogram with UPP 3.09 3.09
51728 Cystometrogram with Void pressure 9.10 NA
studies
51728 TC Cystometrogram with Void pressure 6.08 NA
studies
51728 26 Cystometrogram with Void pressure 3.02 3.02
studies
51729 Cystometrogram with Void pressure 9.77 NA
studies & UPP
51729 TC Cystometrogram with Void pressure 6.13 NA
studies & UPP
51729 26 Cystometrogram with Void pressure 3.64 3.64
studies & UPP
+51797 Voiding pressure study (intra- 3.24 NA
abdominal pressure)
+51797 TC Voiding pressure study (intra- 2.08 NA
abdominal pressure)
+51797 26 Voiding pressure study (intra- 1.16 1.16
abdominal pressure)
51741 Complex Electro-uroflowmetry 0.45 NA
51741 TC Complex Electro-uroflowmetry 0.21 NA
51741 26 Complex Electro-uroflowmetry 0.24 0.24
51784 EMG Anal/urinary muscle study 1.98 NA
patch
51784 TC EMG Anal/urinary muscle study .90 NA
patch
51784 26 EMG Anal/urinary muscle study 1.08 1.08
patch
51785 EMG Anal/urinary muscle study 7.86 NA
needle
Last Updated by the AUGS Coding and Reimbursement Committee on January 2018

Disclaimer: The Coding and Reimbursement Committee of the American Urogynecologic Society (AUGS) assists members with the
application of governmental regulations and guidelines regarding terminology and CPT/ICD coding in urogynecologic practice. Such
information is intended to assist with the coding process as required by governmental regulation and should not be construed as
policy sanctioned by AUGS. AUGS disclaims liability for actions or consequences related to any of the information provided. AUGS
does not endorse the diagnostic protocol or treatment plan designed by the provider.
 1100 Wayne Ave, Suite 825
Silver Spring, MD 20910
301.273.0570 ▪ Fax 301.273.0778
info@[Link] ▪ [Link]

51785 TC EMG Anal/urinary muscle study 5.25 NA

needle
51785 26 EMG Anal/urinary muscle study 2.61 2.61
needle

TC – Technical component only

26 – Professional component only

Billing Tips:
Report the CPT code with the highest RVU first. In most cases, this will be either 51729, 51728, 51727, or
51726.

All other codes are reported with the -51-modifier appended, to designate additional procedures.

Typically, this would be attached to a complex uroflowmetry study done at the same time e.g. 51741-51.

Add on codes, such as 51797, do not need a modifier (e.g. -51 or -59), since by definition they are
only billed “added on” to another procedure.

Urodynamic codes have 0 global days.

An E&M code should only be billed if a separate E&M service is provided, typically for a separate
problem, and would require separate documentation. If so reported, modifier -25 should be added
to this service.

Post void residual is also bundled into the procedure and cannot be billed separately.

Documentation:
A separate report and interpretation should be provided for each of the services that are performed. It
sometimes useful to list the CPT code next to the description of the procedure, e.g. Complex
Uroflowmetry (51741). The report should contain the printed results of each of the test – either
summarized in the report, or as raw data (e.g. CMG curves or graphs). The report should also include
the professional interpretation of the results by the provider who is billing for the services.

Last Updated by the AUGS Coding and Reimbursement Committee on January 2018

Disclaimer: The Coding and Reimbursement Committee of the American Urogynecologic Society (AUGS) assists members with the
application of governmental regulations and guidelines regarding terminology and CPT/ICD coding in urogynecologic practice. Such
information is intended to assist with the coding process as required by governmental regulation and should not be construed as
policy sanctioned by AUGS. AUGS disclaims liability for actions or consequences related to any of the information provided. AUGS
does not endorse the diagnostic protocol or treatment plan designed by the provider.
 1100 Wayne Ave, Suite 825
Silver Spring, MD 20910
301.273.0570 ▪ Fax 301.273.0778
info@[Link] ▪ [Link]

Coding Pitfalls:
Urodynamics can be performed by non-physician practitioners such as physician assistants, nurse, or
medical technician. However, billing for these services requires direct supervision, which means that the
billing physician must be present in the office when that individual performs the urodynamics.

51792 describes a stimulus evoked response, or measurement of bulbocavernosus reflex latency time.
This is a procedure that most typically is performed for erectile dysfunction, and should not be billed at
the time of urodynamic studies.

Reimbursement for flow studies includes both pre- and post-testing (e.g. just before and just after
the cystometrogram) so you can only bill it once on the same day of service.

Do not bill separately for your interpretation of the test results or discussion of the test results with the
patient. This is already being reimbursed under the professional component of the CPT code. If
discussion of a separate diagnosis or unrelated medical decisions are being performed in the same
visit, you may bill for the appropriate E&M code with that separate diagnosis.

Urodynamics that are performed during the global period of another procedure would require a
modifier -79 to designate an unrelated procedure or service performed by the same provider during the
post-operative period. Typically, the ICD 10 code would be different than the code for the initial
procedure. For example, you would use the code for urinary retention or urinary incontinence to code
for the urodynamic studies performed for these indications if they were performed after a vaginal
hysterectomy done for uterine prolapse.

References:
• CPT is a registered trademark of the American Medical Association, Copyright 2018

Last Updated by the AUGS Coding and Reimbursement Committee on January 2018

Disclaimer: The Coding and Reimbursement Committee of the American Urogynecologic Society (AUGS) assists members with the
application of governmental regulations and guidelines regarding terminology and CPT/ICD coding in urogynecologic practice. Such
information is intended to assist with the coding process as required by governmental regulation and should not be construed as
policy sanctioned by AUGS. AUGS disclaims liability for actions or consequences related to any of the information provided. AUGS
does not endorse the diagnostic protocol or treatment plan designed by the provider.