Summary & Overview
CPT 50785: Ureteral Reimplantation to Bladder
CPT code 50785 represents a surgical ureteral reimplantation procedure in which the ureter is transplanted to a different site in the urinary bladder to reestablish unobstructed urine flow. This reconstructive genitourinary surgery is performed to correct ureteral obstruction or malposition and is relevant for hospitals, surgical practices, and payers given its resource intensity and potential inpatient utilization. Nationally, the code matters for surgical quality, utilization monitoring, and payment policy for complex urologic reconstruction.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and the typical site of service, plus benchmarking and policy-oriented content where available. The publication outlines expected coding designation, clinical scenarios that commonly prompt the procedure, and common modifiers used in claims processing. It also summarizes available benchmarks and recent policy updates relevant to payment and prior authorization practices.
The article equips revenue cycle leaders, surgical departments, and policy analysts with a clear understanding of what CPT code 50785 denotes, why it is tracked, and where to focus operational and compliance attention when this procedure appears on a service line.
Billing Code Overview
CPT code 50785 describes a surgical ureteral reimplantation in which the provider transplants the ureter to a new site in the urinary bladder to restore uninterrupted urine flow. The procedure involves creating a new bladder opening and connecting the ureter by suturing the bladder and psoas or by harvesting a long, elliptical flap from the bladder roof.
Service type: Surgical procedure — genitourinary reconstructive surgery
Typical site of service: Inpatient or outpatient hospital operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is a 35–60-year-old adult presenting with symptomatic unilateral ureteral obstruction or vesicoureteral reflux refractory to conservative or endoscopic management. Indications include recurrent febrile urinary tract infections, progressive hydronephrosis, or distal ureteral injury from trauma, prior pelvic surgery, or radiation. Preoperative workup includes renal function tests, urinalysis and urine culture, cross-sectional imaging (CT urogram or renal ultrasound) to define anatomy and obstruction level, and cystoscopy to assess bladder capacity and ureteral orifice. The patient is scheduled for open or robotic/laparoscopic ureteroneocystostomy under general anesthesia. Intraoperative steps include ureteral mobilization, spatulation of the ureter, creation of a new bladder submucosal tunnel or flap (e.g., psoas hitch or Boari flap), tension-free anastomosis with absorbable sutures, possible stent placement (ureteral stent), and bladder closure. Postoperative workflow includes inpatient monitoring for urine output and hematuria, removal of urethral catheter per protocol, imaging (renal ultrasound or cystogram) prior to stent or catheter removal, pain control, and follow-up to assess resolution of obstruction and renal function. Typical site of service is the hospital operating room or an ambulatory surgery center for selected minimally invasive cases.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or operative time is substantially greater than typical due to extensive adhesiolysis or complex reconstruction. |