Summary & Overview
CPT 50728: Revision of Urostomy with Fascial/Hernia Repair
CPT code 50728 identifies a surgical revision of a previously created urostomy with concurrent repair of fascial defects or hernias adjacent to the urinary anastomosis. This procedure is clinically significant for patients with complications such as stoma malfunction, peristomal hernia, or fascial disruption that impair urinary diversion or wound integrity. Nationally, accurate coding of urostomy revision procedures affects surgical quality measurement, claims processing, and resource allocation for complex post-urostomy care. Key payers relevant to coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical intent of the code, typical sites of service, and the service type. The publication outlines common billing contexts and discusses benchmarks and policy considerations that influence coding and payment for complex urostomy management. It also highlights clinical context for why revisions and hernia repairs are performed and notes where input data was not provided. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 50728 describes a surgical procedure to revise an existing urostomy — an artificial opening (stoma) connecting the urinary tract to the skin that was created previously. The procedure includes revision of the stoma and repair of associated fascial defects or hernias around the anastomosis or ureteral tissue.
Service type: Surgical — urostomy revision with fascial/hernia repair
Typical site of service: Hospital inpatient or outpatient surgical facility
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of radical cystectomy and ileal conduit urinary diversion presents with stomal stenosis and recurrent peristomal hernia causing appliance leakage and discomfort. After conservative measures (stoma care, appliance refitting) fail, the patient is scheduled for operative revision of the urostomy and repair of the fascial defect. Preoperative evaluation includes urinalysis, basic labs, cross-sectional imaging of the abdomen/pelvis to assess the conduit and hernia, and anesthesia assessment. In the operating room under general anesthesia, the urology or general surgeon revises the stoma matured to the skin, resects scarred or stenotic bowel segment as needed, and repairs the abdominal wall fascial defect (hernia repair) with primary closure or mesh reinforcement. Intraoperative documentation includes indication, findings (stomal stenosis, hernia size), exact repair performed (stomal refashioning, fascial repair, mesh placement if used), estimated blood loss, drains placed, and the provider performing the service. Postoperative workflow includes wound/stoma care instructions, potential short inpatient observation for pain control and stoma function monitoring, and follow-up with the surgeon and ostomy nurse for appliance fitting and education.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Service not otherwise classified (payer specific) | Use per payer policy when required for reporting unspecified services (rare for this code). |