CPT 50660 Ureteral Excision Reimbursement | OpenPayer

Summary & Overview

CPT 50660: Excision of Abnormal or Malpositioned Ureter

CPT code 50660 documents surgical excision of an abnormal or malpositioned ureter that terminates at an atypical site, using combined abdominal, vaginal, and/or perineal approaches. This code captures a specialized urologic reconstructive procedure with implications for operative planning, site of service selection, and postoperative care. Nationally, accurate coding for complex ureteral surgery affects hospital case mix, physician billing, and claims adjudication for inpatient and outpatient surgical settings.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and the billing landscape relevant to this procedure. The publication summarizes benchmarks where available, highlights coding and documentation considerations, and outlines how this procedure fits into broader urologic surgical services. Data not available in the input is clearly identified for areas such as associated taxonomies and specific ICD-10 diagnoses.

This summary is intended for a national audience of coders, billing analysts, revenue cycle managers, and clinical leaders who need concise guidance on the clinical description and billing context for CPT code 50660.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 50660ureteral surgeryurologysurgical excisionambulatory surgeryinpatient surgeryreconstructive surgeryprocedure coding

Billing Code Overview

CPT code 50660 describes a surgical procedure to remove an abnormal or malpositioned ureter that terminates at an atypical site. The operation is performed through a combination of approaches, including abdominal, vaginal, and/or perineal access, depending on the clinical anatomy and surgical plan.

Service type: Surgical excision of ureter (reconstructive/urologic surgery)
Typical site of service: Hospital inpatient or outpatient surgical setting, or ambulatory surgery center, depending on operative approach and patient factors.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Clinical & Coding Specifications

Clinical Context

A typical patient is a woman presenting with recurrent urinary tract infections, continuous urinary incontinence since childhood, or pelvic pain related to an ectopic ureter terminating into the vagina, vestibule, or urethra. Diagnostic workup includes history, physical exam, urinalysis, urine culture, renal ultrasound, CT urogram or MR urogram, and cystoscopy to localize ureteral insertion. When imaging and endoscopy confirm an abnormal or ectopic ureter not amenable to endoscopic correction, the surgeon plans a definitive reconstructive procedure to excise the abnormal ureter and reimplant or ligate the distal segment. The operation is performed under general anesthesia using an abdominal, vaginal, and/or perineal approach depending on ureteral location and patient anatomy. Typical perioperative workflow includes preoperative antibiotics, informed consent specifying potential need for concurrent procedures (e.g., ureteral reimplantation, nephroureterectomy if nonfunctional kidney), intraoperative cystoscopic assessment, placement of ureteral stents if required, surgical excision/ligation of the ectopic ureter, hemostasis, and layered closure. Postoperative care includes pain control, monitoring for urinary leakage, stent management if placed, and follow-up imaging or renal function testing as indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when operative complexity or time is substantially greater than typical for the procedure (document rationale).

CPT 50650: Ureterectomy with Bladder Cuff for Ureteral Cancer

Taxonomy Code	Specialty	Notes
2080S0201X	Urology	Urologists commonly perform ureteral reconstruction and excision of ectopic or abnormal ureters.
207V00000X	Obstetrics & Gynecology	Gynecologic surgeons may perform this procedure when the approach is vaginal or perineal or when pelvic anatomy involvement exists.
2086S0101X	Pediatric Urology	Pediatric urologists commonly manage ectopic ureters in infants and children and perform this procedure in pediatric populations.
2080P0206X	Female Pelvic Medicine & Reconstructive Surgery	Specialists in pelvic reconstructive surgery may be involved when pelvic floor or vaginal approaches are required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.1`	Obstructive and reflux uropathy	Ectopic or obstructing ureter can cause obstruction and reflux requiring surgical correction.
`N13.6`	Hydronephrosis with ureteral stricture	Ureteral malposition or abnormality can lead to hydronephrosis and need for excision or reimplantation.
`N39.0`	Urinary tract infection, site not specified	Recurrent UTIs are a common presenting problem when an ectopic ureter drains to the lower genital tract.
`N39.3`	Stress incontinence (female)	Ectopic ureteral drainage into the vagina or urethra can present with continuous leakage often mistaken for stress incontinence.
`Q62.1`	Ectopic ureter (congenital)	Congenital ectopic ureter is a primary indication for surgical excision or reimplantation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy, with or without collection of urine specimen, exclusive of catheterization	Preoperative or intraoperative cystoscopic evaluation to localize ureteral orifices and assess bladder anatomy.
`52005`	Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography	Used when ureteral catheterization or retrograde pyelography is performed to delineate ureteral anatomy before excision.
`50590`	Unlisted procedure, kidney	Performed when a concomitant nephrectomy or partial nephrectomy is required for a nonfunctional ipsilateral kidney; unlisted code selected if specific nephroureterectomy code not appropriate.
`50780`	Ureteral ligation, other than for malignancy	Alternative or adjunct procedure when distal ureteral ligation is required without formal reimplantation.
`50948`	Nephrectomy, partial or segmental (separate listings exist)	May be performed prior to or in conjunction with ureteral excision if renal preservation or partial nephrectomy is indicated.

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