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    OpenPayerBilling CodesRepair Procedures on the KidneyCPT cpt-50400-pyeloplasty-ureteropelvic-junction-repair
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    CPT 50400: Pyeloplasty, Ureteropelvic Junction Reconstruction

    Medicare pays $1051 on average nationally for this procedure.

    CPT code 50400 describes a pyeloplasty, a surgical procedure to reconstruct the junction between the renal pelvis and the ureter to correct obstruction; this is a surgical reconstruction service typically performed in an operating room setting, often as inpatient or outpatient urologic surgery involving dissection and reanastomosis of the ureteropelvic junction to restore urinary drainage.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 28–45-year-old adult presenting with recurrent flank pain, intermittent urinary tract infections, or impaired renal function found on imaging. Evaluation includes renal ultrasound, CT urogram or MAG3 renal scan demonstrating ureteropelvic junction (UPJ) obstruction with hydronephrosis and either preserved or decreasing differential renal function. After conservative management or endoscopic attempts fail or are unsuitable, the urologist schedules an operative pyeloplasty to surgically reconstruct the obstructed UPJ and restore drainage.

    Preoperative workflow includes history and physical, review of imaging and nuclear renal scan, preoperative labs (basic metabolic panel, coagulation as indicated), anesthesia evaluation, and informed consent documenting indication and planned approach (open, laparoscopic or robotic). Intraoperative steps include exposure of the renal pelvis and UPJ, excision of the stenotic segment when indicated, spatulated ureteral reimplantation or anastomosis to the renal pelvis with stent placement as needed, hemostasis, and wound closure. Postoperative care includes pain control, monitoring urine output, early ambulation, and imaging follow-up (ultrasound or diuretic renogram) to confirm resolution of obstruction. Typical sites of service are the hospital operating room or ambulatory surgical center, with inpatient stay possible depending on approach and comorbidities.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    50545Pyeloureterostomy; with transposition of ureter (Lich-Gregoir type)Alternative reconstructive technique for UPJ or proximal ureteral obstruction sometimes considered in complex cases
    52630Pyelolithotomy; incision for removal of stone from renal pelvisMay be performed concomitantly if obstructing stone is present at time of pyeloplasty
    52332Cystoureteroscopy, with removal of ureteral calculus (with ureteroscopy)Endoscopic evaluation or stone management may precede or accompany pyeloplasty in the same episode of care
    50700Ureteral reimplantation, reimplant of ureter into bladderDifferent reconstructive procedure for distal ureteral issues; listed as a related reconstructive code in genitourinary surgery
    74450Intravenous pyelogram, radiologic examImaging study that may be used preoperatively to delineate anatomy (historical; CT/renogram more common)

    Related Modifiers

    8 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…
    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…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    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…
    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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    363A00000X
    208U00000X
    208800000X
    213E00000X
    225XN1300X
    173C00000X
    261QB0400X
    103TP2700X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 2

    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-50405-PYELOPLASTY-URETEROPELVIC-JUNCTION-RECONSTRUCTION

    CPT 50405: Pyeloplasty to Reconstruct Ureteropelvic Junction

    CPT-50430-PERCUTANEOUS-URETEROGRAM-NEPHROSTOGRAM-DIAGNOSTIC

    CPT 50430: Percutaneous Ureterogram/Nephrostogram with Contrast

    CPT-50431-NEPHROSTOGRAM-URETEROGRAM-CONTRAST-STUDY

    CPT 50431: Contrast Injection for Nephrostogram or Ureterogram

    CPT-50432-PERCUTANEOUS-NEPHROSTOMY-WITH-IMAGING-GUIDANCE

    CPT 50432: Percutaneous Nephrostomy Catheter Placement with Imaging

    CPT-50433-PERCUTANEOUS-NEPHROSTOMY-IMAGE-GUIDED-RENAL-DRAINAGE

    CPT 50433: Percutaneous Nephrostomy Catheter Placement

    CPT-50434-PERCUTANEOUS-NEPHROSTOMY-TO-NEPHROURETERAL-CONVERSION

    CPT 50434: Image-Guided Nephrostomy to Nephroureteral Catheter Conversion

    CPT-50435-PERCUTANEOUS-NEPHROSTOMY-CATHETER-EXCHANGE-IMAGE-GUIDANCE

    CPT 50435: Percutaneous Nephrostomy Catheter Exchange with Imaging

    CPT-50500-KIDNEY-WOUND-SUTURE-REPAIR

    CPT 50500: Kidney Wound Suture

    CPT-50520-NEPHROCUTANEOUS-PYELOCUTANEOUS-FISTULA-CLOSURE

    CPT 50520: Nephrocutaneous and Pyelocutaneous Fistula Closure

    CPT-50525-RENAL-FISTULA-CLOSURE-ABDOMINAL-APPROACH

    CPT 50525: Closure of Renal Fistula, Abdominal Approach

    Showing 1–10 of 12

    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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