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    v1.0.30
    OpenPayerBilling CodesExcision Procedures on the UreterCPT cpt-50650-ureterectomy-with-bladder-cuff
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    CPT 50650: Ureterectomy with Bladder Cuff Resection

    Medicare pays $947 on average nationally for this procedure.

    CPT code 50650 describes a surgical procedure in which a provider removes all or part of a ureter along with a portion of the bladder cuff, most commonly performed to treat ureteral cancer; this is a major urologic resection typically performed as an inpatient or ambulatory surgical procedure in an operating room or hospital surgical suite and involves excision of the ureter and the adjacent bladder tissue to achieve oncologic control.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male presents with painless gross hematuria and flank pain. Imaging with CT urogram demonstrates a 3.2 cm enhancing mass within the distal portion of the right ureter with suspicion for transitional cell carcinoma. After urologic oncology evaluation and cystoscopic biopsy confirming high-grade urothelial carcinoma, the patient is scheduled for a radical nephroureterectomy with removal of the distal ureter and a bladder cuff. Preoperative workflow includes tumor board review, informed consent documenting cancer diagnosis and extent of resection, preoperative labs and anesthesia evaluation, and verification of laterality. The operative team performs open or minimally invasive removal of the kidney and entire ureter with excision of a segment of bladder (bladder cuff) and appropriate lymph node sampling or dissection as indicated. Postoperative care includes inpatient monitoring for bleeding, urine output, pain control, and follow-up pathology to guide adjuvant therapy decisions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    50590Removal of kidney (simple nephrectomy)Performed when kidney removed separately or when nephrectomy is required for renal involvement; may precede or be combined with ureterectomy in radical nephroureterectomy.
    50947Ureteral reconstruction; reimplantationMay be used when distal ureter is reimplanted into bladder instead of excision with bladder cuff in select reconstructions.
    51720Complex urethral catheterization, with irrigation and/or instillationOften used postoperatively for bladder irrigation or catheter management when indicated.
    38900Lymph node excision; open, superficialUsed if separate lymph node sampling or excisional biopsy is performed during cancer staging.
    88309Surgical pathology, gross and microscopic examinationUsed for definitive pathology processing and reporting of ureter and bladder cuff specimen.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of 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…
    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…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    2080P0206X
    207L00000X
    208000000X
    156FX1700X
    364SA2200X
    251E00000X
    364SP0809X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    C66.1Malignant neoplasm of right ureter
    C66.2Malignant neoplasm of left ureter
    C66.9Malignant neoplasm of unspecified ureter
    C67.0Malignant neoplasm of trigone of bladder
    C67.1Malignant neoplasm of dome of bladder
    C67.2Malignant neoplasm of lateral wall of bladder
    C67.3Malignant neoplasm of anterior wall of bladder
    C67.4Malignant neoplasm of posterior wall of bladder
    C67.5Malignant neoplasm of bladder neck
    C67.6Malignant neoplasm of ureteric orifice

    Showing 1–10 of 24

    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-50660-URETERAL-EXCISION-MALPOSITIONED-URETER

    CPT 50660: Resection of Abnormal or Malpositioned Ureter

    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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