Summary & Overview
CPT 50075: Open Removal of Large Staghorn Renal Calculus
CPT code 50075 denotes an open surgical procedure to remove a large staghorn (struvite) renal calculus via an incision in the kidney. This code captures a high-complexity urologic operation that is clinically important because staghorn stones can compromise renal function, are often infection-associated, and typically require definitive surgical management. Nationally, management of complex renal calculi carries significant clinical and resource implications for inpatient surgical care, anesthesia, and post-operative monitoring.
Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the scope of services represented by the code. The publication summarizes common billing and coding considerations, lists frequently used modifiers (input provided), and highlights where data is not available in the input. It also outlines what to expect in payer coverage discussions and benchmarking topics—including utilization patterns, authorization considerations, and payment policy variations—so clinicians, billing teams, and policy analysts understand the operational implications for managing complex renal stone disease at a national level.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific rates.
Billing Code Overview
CPT code 50075 describes the surgical removal of a large staghorn calculus through an incision in the kidney. A staghorn calculus is a large, branched kidney stone often composed of struvite that can occupy a significant portion of the renal collecting system and is frequently associated with infection.
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Service type: Open surgical nephrolithotomy for removal of a staghorn (complex) renal calculus
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Typical site of service: Inpatient or ambulatory surgical center with operating room capabilities; performed in a hospital operating suite for complex cases
Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents with recurrent flank pain, gross hematuria, and recurrent urinary tract infections. Imaging with non-contrast CT demonstrates a large, branching staghorn calculus occupying the renal pelvis and calyces of the left kidney with associated hydronephrosis and evidence of infected urine. After urology evaluation and preoperative optimization, the patient is brought to the operating room for an open or minimally invasive surgical removal of the staghorn calculus via a direct incision into the renal pelvis or parenchyma. The procedure includes intraoperative stone removal, possible nephrotomy, hemostasis, placement of drains or ureteral stent as indicated, and specimen handling for stone analysis and culture.
Typical workflow:
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Preoperative evaluation: history, labs (CBC, BMP, coagulation), urine culture, imaging review, anesthesia assessment.
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Informed consent documenting risks (bleeding, infection, renal injury), planned approach, and potential need for additional procedures.
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Intraoperative: general anesthesia, incision to access kidney, nephrotomy or pyelotomy, extraction of branched stone fragments, irrigation, control of bleeding, possible placement of nephrostomy tube or ureteral stent, wound closure.
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Postoperative: monitoring for bleeding and infection, pain control, antibiotics guided by culture, imaging follow-up, outpatient stone analysis and metabolic workup referral as indicated.
Coding Specifications
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