Summary & Overview
CPT 50360: Kidney and Ureter Transplantation
CPT code 50360 represents surgical transplantation of a kidney and ureter from a cadaveric or living donor into a recipient without performing a recipient nephrectomy. This procedure is a cornerstone of renal replacement therapy for patients with end-stage kidney disease and has significant clinical and financial implications across the US health system. Nationally, kidney transplantation reduces long-term dialysis dependence, affects organ allocation policy, and involves complex perioperative and immunosuppressive management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical context, common billing and reporting considerations, and the typical site-of-service profile for the code. The publication outlines benchmarks relevant to transplant episode billing, summarizes recent policy updates that affect transplant authorization and coverage, and highlights clinical factors that influence utilization and coding (for example, donor type and perioperative complexity).
The piece is aimed at coding professionals, revenue cycle managers, and clinical leaders who need a clear, national-level reference for CPT code 50360. Data not available in the input are noted where applicable; the content focuses on coding definition, service setting, payer coverage landscape, and practical considerations for institutional billing and policy alignment.
Billing Code Overview
CPT code 50360 describes the transplantation of a kidney and ureter from a cadaver or living donor into a recipient. The procedure as defined excludes removal of a kidney (nephrectomy) from the recipient.
Service type: Organ transplant surgery (kidney transplantation)
Typical site of service: Inpatient hospital operating room or other acute care surgical setting where organ transplant procedures are performed.
Data not available in the input for taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–65-year-old adult with end-stage renal disease (ESRD) admitted for elective kidney transplantation. The recipient has completed pre-transplant evaluation including crossmatch, panel-reactive antibody testing, infectious disease screening, and cardiac clearance. A donor kidney arrives (from a living or deceased donor) and the transplant surgeon performs implantation of the donor kidney and ureter into the recipient; no recipient nephrectomy is performed during this encounter. The clinical workflow includes preoperative time for anesthesia evaluation and immunosuppression induction, intraoperative vascular anastomosis of the renal artery and vein, ureteroneocystostomy with ureteral stent placement as indicated, hemostasis, and postoperative transfer to recovery or transplant unit for monitoring of urine output, graft perfusion, and early immunosuppression management. Typical sites of service are inpatient hospital operating room for deceased donor or living donor transplantation and specialized ambulatory surgical centers for selected living donor-recipient procedures when applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — institutional designation varies by payer | Use when no secondary modifier is applicable; payer-specific reporting may require no modifier field. |