Summary & Overview
CPT 50750: Ureterocalycostomy to Bypass Proximal Ureteral Obstruction
CPT code 50750 denotes ureterocalycostomy, a surgical procedure that connects the upper pole of a healthy, nondilated ureter to a renal calyx to bypass a ureteropelvic junction obstruction and restore upper urinary tract drainage. Nationwide, this code represents a specialized reconstructive urologic surgery used when more common corrective surgeries are not feasible, making it important for surgical coding, coverage decisions, and hospital resource planning.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and typical sites of service, commonly applied modifiers, and guidance on what to expect in payer coverage patterns. The publication summarizes national benchmarks for utilization where available, highlights relevant policy and documentation considerations for surgical reconstruction claims, and provides clinical context on when ureterocalycostomy is indicated versus alternative procedures.
This coverage-oriented summary is intended for coding professionals, surgical departments, and payer policy teams seeking a national perspective on the clinical purpose of CPT code 50750, its role in urologic reconstruction, and the primary topics to address in claims and policy reviews. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 50750 describes a surgical ureterocalycostomy in which the surgeon connects the upper pole of a healthy, nondilated ureter directly to a renal calyx to reestablish urinary drainage. The procedure is performed to bypass a ureteropelvic junction obstruction or other proximal ureteral blockage and restore continuity of the upper urinary tract.
-
Service type: Surgical reconstruction of the upper urinary tract
-
Typical site of service: Inpatient or outpatient hospital setting, typically in an operating room or surgical suite
Clinical & Coding Specifications
Clinical Context
A 34-year-old adult male with recurrent left flank pain, hydronephrosis on imaging, and a history of failed prior pyeloplasty presents for definitive surgical repair. Cross-sectional imaging and retrograde pyelography demonstrate a persistent ureteropelvic junction obstruction with a healthy nondilated upper ureter and scarred renal pelvis. The urologist plans an open ureterocalycostomy to bypass the obstructed ureteropelvic junction by surgically anastomosing the upper pole ureter to a dependent renal calyx.
Preoperative workflow includes history and physical, renal function assessment (serum creatinine, nuclear renal scan if needed), informed consent, and anesthesia evaluation. Intraoperative steps typically include flank exposure (often via an open or flank approach), partial lower pole nephrotomy or calyceal incision to create a dependent calyx, mobilization of the healthy nondilated ureter, spatulation, mucosa-to-mucosa ureterocalyceal anastomosis over a ureteral stent, hemostasis, and layered closure. Postoperative care includes monitoring urine output, pain control, stent management and imaging follow-up (ultrasound or renal scan) to document drainage restoration and renal function recovery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier specified | Rarely appended; use when no modifier applies |