100+ Free CUC Practice Questions

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Peyronie's disease is characterized by:

Fibrous plaque formation in the tunica albuginea causing penile curvature

Bacterial infection of the prostate

Inability to retract the foreskin

Persistent painful erection lasting more than 4 hours

to track

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CPC Certified Professional Coder Study Guide

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2026 Statistics

Key Facts: CUC Exam

150

Total Items

AAPC

5h 40m

Exam Time

AAPC

$299

AAPC Member Fee

AAPC

70%

Passing Score

AAPC

The AAPC CUC consists of 150 MCQ items over 5h40m with 70% passing. Fee $299 AAPC member. Master cystoscopy code series (52000 diagnostic, 52204 with biopsy, 52234-52240 with TURBT, 52332 stent placement), TURP 52601, ureteroscopy with lithotripsy 52353, and urodynamics 51725-51798 with NCCI bundling.

Sample CUC Practice Questions

Try these sample questions to test your CUC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which structure carries urine from the kidney to the urinary bladder?

A.Urethra

B.Ureter

C.Vas deferens

D.Seminal vesicle

Explanation: The ureter is a fibromuscular tube that transports urine from the renal pelvis of the kidney to the urinary bladder. There are two ureters, one for each kidney, each approximately 25-30 cm long.

2The prostate gland is located in which anatomical position relative to the bladder?

A.Superior to the bladder

B.Lateral to the bladder

C.Inferior to the bladder, surrounding the urethra

D.Posterior to the rectum

Explanation: The prostate gland sits inferior to the urinary bladder and surrounds the proximal portion of the urethra (prostatic urethra). This anatomy explains why prostate enlargement (BPH) causes urinary obstruction, and why the gland is accessible by transrectal exam and biopsy.

3Benign prostatic hyperplasia (BPH) primarily affects which zone of the prostate?

A.Peripheral zone

B.Transition zone

C.Central zone

D.Anterior fibromuscular stroma

Explanation: BPH originates in the transition zone, which surrounds the prostatic urethra. As nodular hyperplasia enlarges this zone, it compresses the urethra and causes lower urinary tract symptoms (LUTS). In contrast, prostate cancer most often arises in the peripheral zone.

4Which type of bladder cancer is most common in the United States?

A.Squamous cell carcinoma

B.Adenocarcinoma

C.Urothelial (transitional cell) carcinoma

D.Small cell carcinoma

Explanation: Urothelial carcinoma, formerly called transitional cell carcinoma (TCC), accounts for more than 90% of bladder cancers in the U.S. It arises from the urothelium that lines the bladder, ureters, renal pelvis, and proximal urethra. Smoking is the leading risk factor.

5Stress urinary incontinence is characterized by:

A.Sudden, intense urge to urinate followed by involuntary leakage

B.Involuntary urine loss with coughing, sneezing, or physical exertion

C.Continuous dribbling due to overdistended bladder

D.Inability to sense bladder fullness due to nerve injury

Explanation: Stress urinary incontinence (SUI) is involuntary urine leakage with increased intra-abdominal pressure (cough, sneeze, laugh, exertion) due to weakened pelvic floor support or intrinsic sphincter deficiency. It is most common in women after childbirth and in men post-prostatectomy.

6Cryptorchidism refers to which condition?

A.Testicular torsion

B.Undescended testis

C.Inflammation of the epididymis

D.Fluid collection around the testis

Explanation: Cryptorchidism is the failure of one or both testes to descend into the scrotum during fetal development. It is the most common genital anomaly in male infants. Untreated cryptorchidism increases the risk of infertility and testicular cancer.

7A varicocele is best described as:

A.A fluid-filled sac around the testicle

B.Dilation of the pampiniform venous plexus of the spermatic cord

C.Inflammation of the testicle from viral infection

D.Hardened deposits in the corpus cavernosum of the penis

Explanation: A varicocele is an abnormal dilation of the pampiniform venous plexus draining the testicle. It is most commonly left-sided (because the left spermatic vein drains into the left renal vein at a 90-degree angle) and is associated with male infertility and testicular atrophy.

8Renal cell carcinoma (RCC) most commonly arises from which structure?

A.Renal pelvis urothelium

B.Proximal convoluted tubule epithelium

C.Glomerular podocytes

D.Renal capsule

Explanation: Renal cell carcinoma arises from the proximal convoluted tubule epithelium of the renal cortex. Clear cell RCC is the most common histologic subtype (about 70-80%). Tumors of the renal pelvis are typically urothelial (transitional cell) carcinoma, not RCC.

9Peyronie's disease is characterized by:

A.Inability to retract the foreskin

B.Fibrous plaque formation in the tunica albuginea causing penile curvature

C.Persistent painful erection lasting more than 4 hours

D.Bacterial infection of the prostate

Explanation: Peyronie's disease involves fibrous plaque formation in the tunica albuginea of the corpora cavernosa, causing penile deformity, curvature, and often painful erections. It can interfere with sexual function and may require collagenase injections (Xiaflex) or surgical correction.

10Interstitial cystitis / painful bladder syndrome (IC/PBS) is characterized by:

A.Bacterial infection causing cloudy urine

B.Chronic bladder pain with urinary frequency and urgency without infection

C.Sudden inability to urinate

D.Blood clots obstructing the urethra

Explanation: Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic bladder condition causing pelvic pain, urinary urgency, and frequency in the absence of infection or other identifiable cause. Diagnosis is clinical and may be supported by cystoscopy with hydrodistention showing Hunner's lesions or glomerulations.

About the CUC Exam

AAPC specialty credential for urology coders. Validates expertise in urologic endoscopy (cystoscopy 52000-52356, TURP 52601, ureteroscopy with stone removal/lithotripsy/stenting), open and laparoscopic urologic surgery (nephrectomy, prostatectomy, cystectomy), office urology (catheter, urodynamics 51725-51798, prostate biopsy 55700/55706), and ICD-10-CM genitourinary codes including N40 BPH and CKD staging.

Questions

150 scored questions

Time Limit

5 hours 40 minutes

Passing Score

70%

Exam Fee

$299 AAPC member (AAPC)

CUC Exam Content Outline

15%

Urologic Anatomy and Pathology

Kidneys, ureters, bladder, urethra, prostate, scrotum, testes; BPH, stones, RCC, BCa

25%

CPT Urologic Endoscopy

Cystoscopy 52000-52356, TURP 52601, ureteroscopy 52351-52356, stent placement 52332

20%

CPT Urologic Surgery (Open and Lap)

Nephrectomy 50220-50546, prostatectomy 55810-55866, cystectomy 51580-51590

15%

CPT Office Urology

Catheter 51702/51703, prostate biopsy 55700/55706 (with US 76872), urodynamics 51725-51798

10%

ICD-10-CM Genitourinary

N18.x CKD by stage, N40 BPH, N20.x stones, C61 prostate cancer, C67.x bladder cancer

15%

Modifiers, E/M, Compliance and Pathology Billing

22, 50, 51, 52, 58, 59, 78, 79, LT/RT; USPSTF PSA screening (C grade 55-69), Medicare LCDs

How to Pass the CUC Exam

What You Need to Know

Passing score: 70%
Exam length: 150 questions
Time limit: 5 hours 40 minutes
Exam fee: $299 AAPC member

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CUC Study Tips from Top Performers

1Master TURBT codes by tumor size: 52234 small (<0.5 cm), 52235 medium (0.5-2.0 cm), 52240 large (>2.0 cm or extensive). Code the most extensive when multiple tumors

2Know ureteroscopy hierarchy: 52351 diagnostic; 52352 with stone removal; 52353 with lithotripsy; 52354 with biopsy; 52355 manipulation; 52356 with stent insertion

3Memorize urodynamics bundling: many codes (51725-51798) bundle within session; 51797 voiding pressure study with simultaneous abd pressure; 51798 PVR by US

4Understand modifier 50 vs LT/RT: modifier 50 for bilateral procedures with bilateral indicator 1; LT/RT for unilateral procedures with bilateral indicator 0

Frequently Asked Questions

How are TURBT codes selected?

Cystoscopy with TURBT (transurethral resection of bladder tumor) is coded by tumor SIZE: 52234 (small <0.5 cm), 52235 (medium 0.5-2.0 cm), 52240 (large >2.0 cm OR more extensive). Code the most extensive procedure when multiple tumors removed at same session. Bilateral ureteral stent placement during the same session: add modifier 50 to the stent code. Bladder biopsy without resection: 52204.

How is prostate biopsy coded?

55700 = transperineal or transrectal prostate needle biopsy, single or multiple. 55706 = saturation biopsy by needle (12+ samples). When the urologist performs both the biopsy AND the US guidance: bill 55700 + 76872 (transrectal US) when the urologist owns the equipment and performs both. Some MACs require modifier 26/TC splits. Pathology is billed separately by the lab (88305 per specimen).

What modifier is used for bilateral procedures on paired structures?

Modifier 50 (bilateral) is added when a procedure inherently single-organ is performed on paired structures (kidneys, ureters, testes). Reimburses 150% of the unilateral fee. LT/RT can be used for unilateral procedures. NOT all paired-organ procedures accept 50 — check CMS Physician Fee Schedule bilateral indicator (1 = bilateral surgery rules apply, 50 modifier; 2 = inherent bilateral, no modifier).