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CPT 50280: Open Excision or Deroofing of Renal Cyst(s)

CPT code 50280 describes an open surgical procedure to excise one or more cysts or to remove the covering (deroof) of renal cysts on the kidney surface. The code captures a defined surgical approach to symptomatic or clinically indicated renal cysts and is used across hospital and ambulatory surgical settings. Nationally, accurate coding of this procedure affects hospital billing, surgical quality tracking, and appropriate allocation of surgical resources.

This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 50280, typical sites of service, and which payers commonly reimburse for this open renal cyst procedure. The publication summarizes common modifiers in circulation and highlights where data is not available in the input.

Readers will learn operational benchmarks and policy-relevant considerations related to use of CPT code 50280, including typical clinical scenarios prompting open excision or deroofing of renal cysts, and how the procedure is positioned relative to other surgical approaches. Data not available in the input will be noted where applicable.

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Billing Code Overview

CPT code 50280 describes an open surgical procedure in which the provider excises one or more cysts or removes the covering of one or more cysts on the surface of the kidney. This is a surgical renal cyst excision or deroofing performed through an open incision.

Service type: Open surgical excision/deroofing of renal (kidney) cyst(s).
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center, depending on patient condition and clinical decision-making.

Data not available in the input.

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CPT 50280: Open Excision or Deroofing of Renal Cyst(s)

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Get alerted when payer policies referencing 50280 are released or updated.

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Billing Code Overview

Service type: Open surgical excision/deroofing of renal (kidney) cyst(s).
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center, depending on patient condition and clinical decision-making.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 52-year-old adult referred to a urologist for flank pain and an incidentally discovered complex cortical renal cyst on imaging. After evaluation with renal ultrasound and contrast-enhanced CT showing symptomatic or concerning features (thickened septations, enhancing mural nodularity, or large size causing mass effect), the decision is made for surgical excision of the cyst lining to relieve symptoms and obtain tissue for pathology. The patient presents to a hospital operating room under general anesthesia. Preoperative workflow includes history and physical, consent specific to open renal cyst excision, basic labs (CBC, BMP, coagulation studies), and perioperative antibiotics per facility protocol. Intraoperative steps include a flank or subcostal open incision, exposure of the kidney, identification of one or more cortical cysts, excision of the cyst wall or unroofing of cysts on the renal surface with hemostasis, possible partial nephron-sparing resection if adherent tissue is suspicious, and placement of drains if needed. The procedure may require intraoperative consultation with pathology for frozen section. Postoperative care includes monitoring in PACU, pain control, evaluation of renal function, wound care, and follow-up imaging or clinic visit to review pathology and assess for complications such as bleeding or infection.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician professional component separate from technical facility services (rare for this surgical procedure).
`50`	Bilateral procedure	Use when identical procedures are performed on both kidneys during the same operative session.
`51`	Multiple procedures	Use when `50280` is reported with other distinct surgical CPT codes during the same operative episode.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as documented (e.g., aborted before full excision).
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances (patient instability, severe adhesions).
`54`	Surgical care only	Use when only the surgical portion is billed separately and pre/post-op care is billed by another provider.
`55`	Postoperative management only	Use when only postoperative hospital care is reported by a provider other than the surgeon.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the operation.
`66`	Surgical team	Use when a surgical team approach is documented for a complex open renal procedure.
`78`	Return to operating room for related procedure during global period	Use when a related return to the OR is required for a complication of the initial excision within the global period.
`80`	Assistant surgeon	Use when a surgical assistant is billed for assisting the primary surgeon.
`81`	Minimum assistant surgeon	Use when a minimum assistant (as defined by payer) participates.
`82`	Assistant surgeon (when a qualified resident is not available)	Use when a qualified resident is not available and an assistant is needed.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP provides assistant-at-surgery services and payer accepts `AS`.

Taxonomy Code	Specialty	Notes
208000000X	Urology	Urologists most commonly perform open renal cyst excision when indicated.
207P00000X	General Practice	General surgeons may perform open renal procedures in some settings or trauma-related cases.
208800000X	Nephrology	Nephrologists do not typically perform surgery but are involved in perioperative renal management and consultation.
207L00000X	Obstetrics and Gynecology	Not typical; listed only when rare cross-specialty involvement occurs (use is uncommon).
363L00000X	Physician Assistant	Physician assistants frequently assist in perioperative and intraoperative roles; taxonomy reflects provider role.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N28.1`	Cyst of kidney, acquired	Direct indication for renal cyst excision when symptomatic or complicated.
`N28.89`	Other specified disorders of kidney and ureter	Used for atypical renal cystic disorders when a specific code is not available.
`N13.6`	Pyonephrosis and nephrostomy complications	Relevant when an infected collecting system or pyonephrosis requires drainage or excision of infected cystic tissue.
`N20.0`	Calculus of kidney	Included when a renal stone is associated with focal cystic change or contributes to symptoms prompting surgery.
`R10.1`	Pain localized to upper abdomen	Symptom code that may accompany flank pain leading to imaging and discovery of renal cysts.
`R31.0`	Gross hematuria	Hematuria may prompt evaluation and surgical management if related to a suspicious renal cyst.
`D41.4`	Neoplasm of uncertain behavior of kidney, except renal pelvis	Used when cystic lesion is indeterminate and tissue diagnosis is required via excision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50240`	Nephrectomy, partial, including partial ureterectomy, single or multiple segments; excision of tumor, wedge resection or polar resection	Performed when a cyst is suspicious for malignancy and a nephron-sparing resection beyond simple cyst excision is required.
`50590`	Renal biopsy, percutaneous, including imaging guidance when performed; single or multiple samples	May be performed preoperatively for tissue diagnosis if imaging is indeterminate prior to open excision.
`50547`	Nephrostomy, percutaneous or open; catheter placement, with or without injection for imaging	Used when decompression of a collecting system or access is needed prior to definitive surgery in complex cases.
`49422`	Placement of percutaneous drainage catheter, percutaneous or open, for renal collection	May be used to drain infected renal cysts or perinephric abscesses as a temporizing measure before open excision.
`50300`	Cystoscopy, diagnostic; with or without collection of specimen(s) by brushing or washing	Performed pre- or postoperatively if hematuria evaluation or urinary tract assessment is required in the workup.

CPT 50200: Percutaneous Renal Aspiration for Diagnostic Biopsy

CPT-50205-PERCUTANEOUS-KIDNEY-BIOPSY-SAMPLING

CPT 50205: Percutaneous Kidney Biopsy Sample Collection

CPT-50220-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50220: Nephrectomy (Kidney Removal)

CPT-50225-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50225: Nephrectomy (Kidney Removal)

CPT-50230-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50230: Nephrectomy, Kidney Removal

CPT-50234-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50234: Nephrectomy, Kidney Removal

CPT-50236-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50236: Nephrectomy (Kidney Removal)

CPT-50240-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50240: Nephrectomy, Kidney Removal

CPT-50250-KIDNEY-CRYOABLATION-CRYOSURGERY

CPT 50250: Kidney Cryoablation/Cryosurgery

CPT-50290-EXCISION-KIDNEY-SURROUNDING-TISSUE-CYST

CPT 50290: Excision of Cyst from Tissue Surrounding Kidney

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician professional component separate from technical facility services (rare for this surgical procedure).
`50`	Bilateral procedure	Use when identical procedures are performed on both kidneys during the same operative session.
`51`	Multiple procedures	Use when `50280` is reported with other distinct surgical CPT codes during the same operative episode.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as documented (e.g., aborted before full excision).
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances (patient instability, severe adhesions).
`54`	Surgical care only	Use when only the surgical portion is billed separately and pre/post-op care is billed by another provider.
`55`	Postoperative management only	Use when only postoperative hospital care is reported by a provider other than the surgeon.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the operation.
`66`	Surgical team	Use when a surgical team approach is documented for a complex open renal procedure.
`78`	Return to operating room for related procedure during global period	Use when a related return to the OR is required for a complication of the initial excision within the global period.
`80`	Assistant surgeon	Use when a surgical assistant is billed for assisting the primary surgeon.
`81`	Minimum assistant surgeon	Use when a minimum assistant (as defined by payer) participates.
`82`	Assistant surgeon (when a qualified resident is not available)	Use when a qualified resident is not available and an assistant is needed.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP provides assistant-at-surgery services and payer accepts `AS`.

Taxonomy Code	Specialty	Notes
208000000X	Urology	Urologists most commonly perform open renal cyst excision when indicated.
207P00000X	General Practice	General surgeons may perform open renal procedures in some settings or trauma-related cases.
208800000X	Nephrology	Nephrologists do not typically perform surgery but are involved in perioperative renal management and consultation.
207L00000X	Obstetrics and Gynecology	Not typical; listed only when rare cross-specialty involvement occurs (use is uncommon).
363L00000X	Physician Assistant	Physician assistants frequently assist in perioperative and intraoperative roles; taxonomy reflects provider role.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N28.1`	Cyst of kidney, acquired	Direct indication for renal cyst excision when symptomatic or complicated.
`N28.89`	Other specified disorders of kidney and ureter	Used for atypical renal cystic disorders when a specific code is not available.
`N13.6`	Pyonephrosis and nephrostomy complications	Relevant when an infected collecting system or pyonephrosis requires drainage or excision of infected cystic tissue.
`N20.0`	Calculus of kidney	Included when a renal stone is associated with focal cystic change or contributes to symptoms prompting surgery.
`R10.1`	Pain localized to upper abdomen	Symptom code that may accompany flank pain leading to imaging and discovery of renal cysts.
`R31.0`	Gross hematuria	Hematuria may prompt evaluation and surgical management if related to a suspicious renal cyst.
`D41.4`	Neoplasm of uncertain behavior of kidney, except renal pelvis	Used when cystic lesion is indeterminate and tissue diagnosis is required via excision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50240`	Nephrectomy, partial, including partial ureterectomy, single or multiple segments; excision of tumor, wedge resection or polar resection	Performed when a cyst is suspicious for malignancy and a nephron-sparing resection beyond simple cyst excision is required.
`50590`	Renal biopsy, percutaneous, including imaging guidance when performed; single or multiple samples	May be performed preoperatively for tissue diagnosis if imaging is indeterminate prior to open excision.
`50547`	Nephrostomy, percutaneous or open; catheter placement, with or without injection for imaging	Used when decompression of a collecting system or access is needed prior to definitive surgery in complex cases.
`49422`	Placement of percutaneous drainage catheter, percutaneous or open, for renal collection	May be used to drain infected renal cysts or perinephric abscesses as a temporizing measure before open excision.
`50300`	Cystoscopy, diagnostic; with or without collection of specimen(s) by brushing or washing	Performed pre- or postoperatively if hematuria evaluation or urinary tract assessment is required in the workup.

CPT 50200: Percutaneous Renal Aspiration for Diagnostic Biopsy

CPT-50205-PERCUTANEOUS-KIDNEY-BIOPSY-SAMPLING

CPT 50205: Percutaneous Kidney Biopsy Sample Collection

CPT-50220-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50220: Nephrectomy (Kidney Removal)

CPT-50225-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50225: Nephrectomy (Kidney Removal)

CPT-50230-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50230: Nephrectomy, Kidney Removal

CPT-50234-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50234: Nephrectomy, Kidney Removal

CPT-50236-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50236: Nephrectomy (Kidney Removal)

CPT-50240-NEPHRECTOMY-KIDNEY-REMOVAL

CPT 50240: Nephrectomy, Kidney Removal

CPT-50250-KIDNEY-CRYOABLATION-CRYOSURGERY

CPT 50250: Kidney Cryoablation/Cryosurgery

CPT-50290-EXCISION-KIDNEY-SURROUNDING-TISSUE-CYST

CPT 50290: Excision of Cyst from Tissue Surrounding Kidney

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 50280: Open Excision or Deroofing of Renal Cyst(s)

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Billing Code Overview

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CPT 50280: Open Excision or Deroofing of Renal Cyst(s)

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References