Cardiology Question for the Week of April 6, 2026
Bryan Nordley
April 6, 2026
How should coders report primary and add-on codes for endovenous ablation when multiple veins and bilateral extremities are treated?
CPT® codes 50436 and 50437 were introduced this year for dilation of a new or existing tract for endourologic procedures. As with most bundled codes, 50436 and 50437 are very similar, but do have important differences, and are very inclusive.
A tract is created percutaneously (through the body wall) into the kidney to allow for passage of a device into the kidney and/or ureter. This would be done to create access, or enlarge an existing access, for endourologic procedures to be performed beyond this point (the dilated tract) such as kidney stone removal. The intent of these new codes is very clear and very specific – they are for endourologic procedures only.
Some key phrases in the documentation that can help identify this procedure include balloon dilator, serial dilator or sheath.
There’s a number of similarities between the codes, including:
Code 50436 is reported when there is an existing tract and that tract is enlarged to allow for use larger instruments during an endourologic procedure.
Code 50437 is reported instead of code 50436 when there is no existing tract and the radiologist must create a new access as well as dilate the tract for the surgeon.
For more information on these procedures, plus other genitourinary IR services, check out our Genitourinary Interventional Radiology Coding webcast featuring prominent interventional radiology coding expert Jeff Majchrzak, BA, RCC, CIRCC.
How should coders report primary and add-on codes for endovenous ablation when multiple veins and bilateral extremities are treated?
Under what conditions can we bill for 94640 and 94664 on the same date of service?
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