Urology Coding Alert

Keep this list handy to check your urological surgery codes before attaching 50, LT, or RT for Medicare claims. 

While the Medicare Physician Fee Schedule contains the details about when you can bill a code bilaterally, having to go online or flip through pages of printed info can make finding the info you need a real pain. Ease your bilateral billing headaches with this quick reference chart that shows which urology codes you can bill with modifiers 50, LT or RT, and which you can’t.

We’ve broken down the codes according to whether the Medicare Physician Fee Schedule lists them with a 0, 1, 2, or 3 indicator, with these definitions: 

0 — You cannot append modifier 50, but you can append LT or RT.
1 — You can append modifier 50.
2 — The code already specifies a bilateral procedure, so you should not append modifier 50, LT or RT to denote a procedure’s bilateral nature.
3 — When performed bilaterally, append modifier 50 or LT/RT. Reimbursement is determined at 100 percent of the allowed for each side.

Bilateral Procedure Indicator 0: 

Do not report these codes bilaterally.

50020, 50250, 50290, 50323, 50325, 50327, 50328, 50329, 50360, 50370, 50380, 50500, 50520, 50525, 50526, 50562, 50660, 50686, 50688, 50690, 50722, 50725, 50727, 50728, 50770, 50810, 50825, 50830, 50845, 50920, 50930, 51020, 51030, 51040, 51045, 51050, 51060, 51065, 51080, 51100, 51101, 51102, 51500, 51520, 51525, 51530, 51550, 51555, 51565, 51570, 51580, 51590, 51596, 51597, 51600, 51605, 51610, 51700, 51701, 51702, 51703, 51705, 51710, 51715, 51720, 51725, 51725-TC, 51725-26, 51726, 51726-TC, 51726-26, 51727, 51727-TC, 51727-26, 51728, 51728-TC, 51728-26, 51729, 51729-TC, 51729-26, 51736, 51736-TC, 51736- 26, 51741, 51741-TC, 51741-26, 51784, 51784-TC, 51784-26, 51785, 51785-TC, 51785-26, 51792, 51792-TC, 51792-26, 51797, 51797-TC, 51797-26, 51798, 51800, 51840, 51841, 51845, 51860, 51865, 51880, 51900, 51920, 51925, 51940, 51960, 51980, 51990, 51992, 51999, 52000, 52001, 52005, 52010, 52204, 52214, 52224, 52234, 52235, 52240, 52250, 52260, 52265, 52270, 52275, 52276, 52277, 52281, 52282, 52283, 52285, 52287, 52305, 52310, 52315, 52317, 52318, 52351, 52400, 52402, 52450, 52500, 52601, 52630, 52640, 52647, 52648, 52649, 52700, 53000, 53010, 53020, 53025, 53040, 53060, 53080, 53085, 53200, 53210, 53215, 53220, 53230, 53235, 53240, 53250, 53260, 53265, 53270, 53275, 53400, 53405, 53410, 53415, 53420, 53425, 53430, 53431, 53440, 53442, 53444, 53445, 53446, 53447, 53448, 53449, 53450, 53460, 53500, 53502, 53505, 53510, 53515, 53520, 53600, 53601, 53605, 53620, 53621, 53660, 53661, 53665, 53850, 53852, 53855, 53860, 53899, 54000, 54001, 54015, 54050, 54055, 54056, 54057, 54060, 54065, 54100, 54105, 54110, 54111, 54112, 54115, 54120, 54125, 54150, 54160, 54161, 54162, 54163, 54164, 54200, 54205, 54220, 54230, 54231, 54235, 54240, 54240-TC, 54240-26, 54250, 54250-TC, 54250-26, 54300, 54304, 54308, 54312, 54316, 54318, 54322, 54324, 54326, 54328, 54332, 54336, 54340, 54344, 54348, 54352, 54360, 54380, 54385, 54390, 54400, 54401, 54405, 54406, 54408, 54410, 54411, 54415, 54416, 54417, 54420, 54435, 54440, 54450, 54860, 54861, 54865, 54900, 55040, 55100, 55110, 55120, 55150, 55175, 55180, 55700, 55705, 55706, 55720, 55725, 55801, 55810, 55812, 55821, 55831, 55840, 55842, 55860, 55862, 55866, 55870, 55873, 55875, 55876, 55899, 55920, 57160, 57220, 57230, 57240, 57282, 57283, 57284, 57285, 57287, 57288, 57289, 57423, 57425

Bilateral Procedure Indicator 1: 

You may report these codes bilaterally.

50010, 50040, 50045, 50060, 50065, 50070, 50075, 50080, 50081, 50100, 50120, 50125, 50130, 50135, 50200, 50205, 50220, 50225, 50230, 50234, 50236, 50240, 50280, 50320, 50340, 50365, 50382, 50384, 50385, 50386, 50387, 50389, 50390, 50391, 50392, 50393, 50394, 50395, 50396, 50398, 50400, 50405, 50541, 50542, 50543, 50544, 50545, 50546, 50547, 50548, 50549, 50551, 50553, 50555, 50557, 50561, 50570, 50572, 50574, 50575, 50576, 50580, 50590, 50592, 50593, 50600, 50605, 50610, 50620, 50630, 50650, 50684, 50700, 50715, 50740, 50750, 50760, 50780, 50782, 50783, 50785, 50800, 50815, 50820, 50840, 50860, 50900, 50940, 50945, 50947, 50948, 50949, 50951, 50953, 50955, 50957, 50961, 50970, 50972, 50974, 50976, 50980, 51535, 52007, 52320, 52325, 52327, 52330, 52332, 52334,  52341, 52342, 52343, 52344, 52345, 52346, 52352, 52353, 52354, 52355, 52356, 54500, 54505, 54512, 54520, 54522, 54530, 54535, 54550, 54560, 54600, 54620, 54640, 54650, 54660, 54670, 54680, 54690, 54692, 54699, 54700, 54800, 54830, 54840, 55000, 55060, 55400, 55500, 55520, 55530, 55535, 55540, 55550, 55559, 55600, 55605, 55650, 55680

Bilateral Procedure Indicator 2: 

Do not report these codes bilaterally.

50540, 51575, 51585, 51595, 51820, 52290, 52300, 52301, 54130, 54135, 54430, 54901, 55041, 55200, 55250, 55300, 55450, 55815, 55845, 55865, 

Bilateral Procedure Indicator 3:

Report these codes with modifier 50 or LT/RT when performed bilaterally.

None

Note: If a procedure is divided into professional (modifier 26) and technical components (TC), the components usually have the same bilateral status.