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    v1.0.30
    OpenPayerBilling CodesRenal Transplantation ProceduresCPT cpt-50329-renal-allograft-preparation-with-arterial-anastomosis
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    CPT 50329: Renal Allograft Preparation with Arterial Joining

    Medicare pays $163 on average nationally for this procedure.

    CPT code 50329 describes preparation of a renal allograft from a cadaver or living donor that includes joining arteries to ready the kidney for transplantation; the service is a surgical graft preparation procedure (organ procurement/bench work) typically performed in an operating room or transplant center setting prior to implantation.

    For related coverage guidance, see recent payer policy updates: Vafseo (vadadustat) for anemia in CKD on dialysis, Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family Plans, Kerendia (finerenone) — Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old patient with end-stage renal disease from diabetic nephropathy receives a compatible kidney allograft from a living donor. The transplant surgeon and operating team perform back-table preparation of the donor kidney prior to implantation. Back-table preparation includes careful inspection, removal of excess perinephric fat, trimming of the renal artery(s) and vein, identification and repair of multiple arterial branches, creation of a single arterial anastomotic cuff if needed, reconstruction of accessory arteries, and ensuring adequate ureteral length and perfusion. The specimen is kept cold on ice slush and perfused with preservation solution until ready for implantation.

    The clinical workflow includes donor organ arrival and verification, sterile back-table setup in the operating room or adjacent prep room, vascular reconstruction and arterial joining or patching as indicated, ureteral preparation, hemostasis checks, documentation of organ ischemia time, and transfer of the prepared graft to the recipient operative field for vascular and ureteral anastomoses. Intraoperative communication between the procurement and transplant teams and clear documentation of reconstruction steps and times are performed for coding and transplantation registry reporting.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    50300Transplantation of whole adult or pediatric cadaveric kidney (including recipient nephrectomy when performed)Primary recipient procedure; follows graft preparation with vascular and ureteral anastomoses.
    50320Removal of donor kidney, from cadaveric donor, for transplantationPrior procurement step; graft preparation (50329) occurs after removal and during back-table reconstruction.
    50360Donor nephrectomy, laparoscopic, living donorLiving donor nephrectomy precedes back-table preparation of the allograft when source is a living donor.
    34832Use of cardiopulmonary bypass (list separately in addition to primary cardiac procedure)Rarely applicable; listed when complex hemodynamic support is required during transplantation.
    36415Collection of venous blood by venipuncturePerformed perioperatively for crossmatch and laboratory testing; supports compatibility testing and transfusion management.
    36556Insertion of non-tunneled centrally inserted central venous catheterOften placed for perioperative management of transplant recipient; performed before or during transplant hospitalization.

    Related Modifiers

    12 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…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    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…
    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…
    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…
    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207P00000X
    208100000X
    207W00000X
    246Z00000X
    246ZB0500X
    133N00000X
    156FX1800X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 3

    10 rows

    PolicyPayerEffective Date
    Vafseo (vadadustat) for anemia in CKD on dialysisCigna2026-08-15
    Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family PlansCigna2026-08-15
    Kerendia (finerenone) — Coverage CriteriaBlue Cross Blue Shield - Iowa2026-08-05
    Voyxact (sibeprenlimab-szsl) — Prior authorization / medical necessity for primary IgA nephropathyColorado Rocky Mountain Health Plans2026-08-01
    Oxlumo (lumasiran) and Rivfloza (nedosiran) — Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Korsuva (difelikefalin) — Medical Benefit Drug Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Complement Inhibitors - EmpaveliCigna2026-08-01
    Tolvaptan (Jynarque)Cigna2026-08-01
    Nephrology - Filspari (sparsentan) coverageCigna2026-08-01
    Rivfloza (nedosiran) prior authorization for PH1UnitedHealthcare2026-08-01

    Related Codes

    CPT-50300-NEPHRECTOMY-KIDNEY-REMOVAL

    CPT 50300: Nephrectomy, Kidney Removal

    CPT-50320-NEPHRECTOMY-KIDNEY-REMOVAL

    CPT 50320: Nephrectomy, Removal of Kidney or Partial Kidney

    CPT-50323-CADAVER-DONOR-KIDNEY-BACK-TABLE-PREPARATION

    CPT 50323: Donor Kidney Back Table Preparation (Cadaver)

    CPT-50325-DONOR-KIDNEY-BACK-TABLE-PREPARATION

    CPT 50325: Living Donor Kidney Back Table Preparation

    CPT-50327-RENAL-VEIN-BACKBENCH-RECONSTRUCTION

    CPT 50327: Backbench Venous Reconstruction of Donor Kidney

    CPT-50328-ARTERIAL-ALLOGRAFT-PREPARATION-FOR-KIDNEY-TRANSPLANT

    CPT 50328: Arterial Allograft Preparation for Kidney Transplant

    CPT-50340-NEPHRECTOMY-KIDNEY-REMOVAL

    CPT 50340: Nephrectomy, Kidney Removal

    CPT-50360-KIDNEY-AND-URETER-TRANSPLANTATION

    CPT 50360: Kidney and Ureter Transplantation

    CPT-50365-KIDNEY-TRANSPLANT-WITH-RECIPIENT-NEPHRECTOMY

    CPT 50365: Kidney and Ureter Transplant with Recipient Nephrectomy

    CPT-50370-KIDNEY-ALLOGRAFT-EXPLANTATION-DUE-TO-REJECTION

    CPT 50370: Removal of Failed Transplanted Kidney

    Showing 1–10 of 11

    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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