Summary & Overview
CPT 50900: Ureteral Wall Repair to Restore Lumen Patency
CPT code 50900 denotes surgical repair of a tear or discontinuity in the ureteral wall to restore lumen patency, typically performed after ureteral injury or following stone extraction. This code captures a focused urologic reconstruction procedure that can be performed in inpatient or outpatient surgical settings and has implications for operative coding, resource use, and post-procedure care.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context and service setting for 50900 and will learn what to expect in national coverage and coding practice: procedural definition, typical sites of service, and the clinical scenarios prompting use of the code. Benchmarks, reimbursement trends, and payer-specific edits are discussed where available; if payer-specific details are not present in the source, the summary indicates data not available.
This national-level briefing is intended for coding professionals, practice administrators, and clinicians involved in urologic surgery who need a clear reference to the procedural meaning of 50900, its clinical role, and where to look for further payer guidance and documentation requirements.
Billing Code Overview
CPT code 50900 describes surgical repair of a tear or discontinuity in the wall of the ureter. The procedure is performed to restore the patency of the ureteral lumen, commonly after injury or following removal of stones from the ureter.
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Service type: Surgical procedure for ureteral repair
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Typical site of service: Operating room or surgical suite in an inpatient or outpatient hospital setting, or ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 56-year-old male presents after ureteroscopic stone removal during which the surgeon identifies a longitudinal tear in the mid-ureter with leakage of urine and concern for stricture or loss of lumen integrity. The patient is taken to the operating room under general anesthesia. The urologist exposes the injured ureter, assesses the defect, and performs a primary ureterorrhaphy by approximating the ureteral edges with interrupted absorbable sutures to restore lumen patency and prevent extravasation. A ureteral stent is commonly placed intraoperatively to support healing and maintain drainage. The patient is monitored postoperatively for urinary output, flank pain, hematuria, and signs of infection. Typical workflow steps include preoperative imaging (CT or retrograde pyelography), intraoperative identification of the injury, primary repair with suturing, stent placement if indicated, and postoperative follow-up with imaging or stent removal.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds typical for primary ureterorrhaphy. |
23 | Unusual anesthesia | Use if general anesthesia is required for a procedure that is normally performed with local/regional anesthesia but was made necessary by patient condition. |