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    v1.0.30
    OpenPayerBilling CodesLaparoscopic Procedures on the KidneyCPT cpt-50545-radical-nephrectomy-kidney-and-surrounding-structures
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    CPT 50545: Radical Nephrectomy Including Gerota's Fascia

    Medicare pays $1205 on average nationally for this procedure.

    CPT code 50545 describes a radical nephrectomy in which the provider removes a kidney along with surrounding structures such as Gerota’s fascia, nearby lymph nodes, the adrenal gland if indicated, and associated fatty tissue; this is a surgical extirpation procedure generally performed in an inpatient or hospital-based operating room setting for treatment of renal masses or other complex renal disease where complete removal is required.

    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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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 58-year-old with a renal mass suspicious for renal cell carcinoma found on imaging who is scheduled for a radical nephrectomy. The patient presents after cross-sectional imaging (CT or MRI) demonstrating a solid enhancing renal lesion with possible perinephric fat involvement or regional lymphadenopathy. Preoperative workflow includes history and physical, laboratory testing (CBC, CMP, coagulation studies), informed consent discussing removal of the kidney and surrounding structures (Gerota's fascia, perinephric fat, regional lymph nodes, possible adrenal gland), anesthetic evaluation, and medication reconciliation. Intraoperative workflow involves a general anesthetic, open or laparoscopic approach to remove the kidney en bloc with associated fatty tissue and regional nodes; possible adrenalectomy if tumor location or intraoperative findings indicate. Postoperative care includes monitoring in PACU, pain control, early ambulation, renal function monitoring, pathology submission of the nephrectomy specimen, and discharge planning with follow-up for oncology or urology as needed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    50220Removal of transplanted kidney (nephrectomy), totalAlternative nephrectomy code when removing a transplanted kidney
    50544Laparoscopic radical nephrectomy, including removal of regional lymph nodes when performedMinimally invasive approach commonly used instead of open 50545
    50380Nephrectomy, partial, including tumor excisionPerformed when nephron-sparing surgery is appropriate; alternative to radical nephrectomy
    55700Prostatectomy (radical), retropubic; with or without lymphadenectomyExample of concurrent or staged urologic oncologic procedures when indicated
    36415Collection of venous blood by venipunctureCommon preoperative laboratory procedure performed prior to nephrectomy

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    207RP1001X
    207L00000X
    246QH0401X
    163WC1600X
    1223P0221X
    176P00000X
    225C00000X

    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-50541-LAPAROSCOPIC-RENAL-CYST-ABLATION-CRYO-RFA

    CPT 50541: Laparoscopic Destruction of Renal Cysts

    CPT-50542-LAPAROSCOPIC-RENAL-MASS-ABLATION-CRYO-RADIOFREQUENCY

    CPT 50542: Laparoscopic Destruction of Renal Mass Lesion(s)

    CPT-50543-LAPAROSCOPIC-PARTIAL-NEPHRECTOMY

    CPT 50543: Laparoscopic Partial Nephrectomy

    CPT-50544-PYELOPLASTY-URETEROPELVIC-JUNCTION-REPAIR

    CPT 50544: Pyeloplasty to Repair Ureteropelvic Junction Obstruction

    CPT-50546-LAPAROSCOPIC-NEPHRECTOMY-WITH-PARTIAL-URETERECTOMY

    CPT 50546: Laparoscopic Nephroureterectomy with Partial Ureter Removal

    CPT-50547-LAPAROSCOPIC-DONOR-NEPHRECTOMY-COLD-PRESERVATION

    CPT 50547: Laparoscopic Living Donor Nephrectomy

    CPT-50548-LAPAROSCOPIC-NEPHROURETERECTOMY-KIDNEY-AND-URETER-REMOVAL

    CPT 50548: Laparoscopic Nephroureterectomy

    CPT-50549-LAPAROSCOPIC-RENAL-UNLISTED-PROCEDURE

    CPT 50549: Laparoscopic Renal Procedure, Unlisted

    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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