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    OpenPayerBilling CodesIncision Procedures on the KidneyCPT cpt-50100-upj-repair-renal-vessel-repositioning
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    CPT 50100: Reposition/Incision of Aberrant Renal Vessels for UPJ Obstruction

    Medicare pays $1033 on average nationally for this procedure.

    CPT code 50100 describes a surgical procedure to reposition or incise aberrant renal vessels to relieve obstruction at the ureteropelvic junction (UPJ); this is a pyeloplasty-type open surgical repair typically performed by urology or transplant surgery teams as an inpatient or outpatient surgical service in an operating room or hospital surgical suite to restore normal urine drainage from the renal pelvis into the ureter.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

    Progress1 / 7

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    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old adult presents with intermittent flank pain, recurrent urinary tract infections, and imaging demonstrating hydronephrosis due to a ureteropelvic junction (UPJ) obstruction caused by an aberrant renal vessel crossing the UPJ. After noninvasive evaluation including renal ultrasonography and CT urogram confirming extrinsic vascular compression and reduced drainage on a diuretic renal scan, the urologist schedules surgery. In the operating room under general anesthesia, the surgeon performs a pyeloplasty with relocation or incision of the aberrant renal vessel (CPT 50100) to relieve the obstruction. Typical workflow includes preoperative consent and imaging review, intraoperative identification of the aberrant vessel and UPJ, vascular mobilization or incision with preservation of renal perfusion, reconstruction of the UPJ (pyeloplasty), intraoperative assessment of urinary drainage, and postoperative monitoring for bleeding, urine leak, and renal function. Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center depending on clinical status and institutional practice. Common perioperative providers include urologists (pediatric or adult), anesthesiologists, and operating room nursing staff.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    50590Ureteropyelostomy, pyeloplasty or pyeloureterostomy, dismembered (e.g., Anderson-Hynes)Commonly performed with or as the reconstructive technique after mobilization of an aberrant vessel causing UPJ obstruction; may be billed when the dismembered pyeloplasty is performed as the primary repair
    50592Pyeloplasty or ureteropyelostomy, laparoscopicLaparoscopic approach alternative to open CPT 50100 technique for UPJ repair when minimally invasive surgery is used; may be used when vessel transposition is done laparoscopically
    50010Exploration of renal artery; without reconstructionMay be performed if additional renal vascular exploration is required during management of aberrant vessels
    50400Nephrostomy, percutaneous or open, drainage for hydronephrosisMay be performed preoperatively for decompression of infected or obstructed systems prior to definitive repair
    74460Radiologic, retrograde pyelography, with or without injection for visualization of the collecting systemDiagnostic imaging often performed intraoperatively or preoperatively to define the UPJ anatomy and aberrant vessels

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2080P0208X
    2080P0206X
    2084P0800X
    2080P0214X
    374T00000X
    3747A0650X
    2084S0012X
    207ZP0007X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    I12.0Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
    I12.9Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
    N11.0Nonobstructive reflux-associated chronic pyelonephritis
    N11.1Chronic obstructive pyelonephritis
    N11.9Chronic tubulo-interstitial nephritis, unspecified
    N13.2Hydronephrosis with renal and ureteral calculous obstruction
    N13.30Unspecified hydronephrosis
    N13.4Hydroureter
    N13.6Pyonephrosis
    N13.8Other obstructive and reflux uropathy

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-50010-RENAL-DIAGNOSTIC-EXPLORATION-KIDNEY

    CPT 50010: Diagnostic Exploration of Kidney

    CPT-50020-OPEN-DRAINAGE-RENAL-PERIRENAL-ABSCESS

    CPT 50020: Open Drainage of Renal or Perirenal Abscess

    CPT-50040-CREATION-OF-RENAL-CUTANEOUS-FISTULA-NEPHROSTOMY

    CPT 50040: Open Nephrostomy for Urinary Obstruction

    CPT-50045-URINARY-OBSTRUCTION-RELIEF-SURGICAL-PROCEDURE

    CPT 50045: Surgical Relief of Urinary Tract Obstruction

    CPT-50060-SURGICAL-REMOVAL-KIDNEY-STONE

    CPT 50060: Surgical Removal of Kidney Stones (Nephrolithiasis)

    CPT-50065-NEPHROLITHOTOMY-SECONDARY-PROCEDURE-RENAL-STONE-REMOVAL

    CPT 50065: Nephrolithotomy for Kidney Stone Removal

    CPT-50070-KIDNEY-INCISION-STONE-REMOVAL-CONGENITAL-MALFORMATION

    CPT 50070: Nephrolithotomy for Renal Calculi with Kidney Malformation

    CPT-50075-OPEN-NEPHROLITHOTOMY-STAGHORN-CALCULUS-REMOVAL

    CPT 50075: Nephrolithotomy for Staghorn Renal Calculus

    CPT-50080-PERCUTANEOUS-ANTEGRADE-RENAL-STONE-REMOVAL-SIMPLE

    CPT 50080: Percutaneous Nephrolithotomy, Antegrade Stone Removal (Simple)

    CPT-50081-PERCUTANEOUS-ANTEGRADE-RENAL-URETERAL-STONE-REMOVAL-COMPLEX

    CPT 50081: Percutaneous Antegrade Removal of Kidney/Ureteral Stones

    Showing 1–10 of 13

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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