Summary & Overview
CPT 50930: Excision of Ureterovisceral Fistula and Repair
CPT code 50930 denotes surgical excision of a ureterovisceral fistula with repair of the adjacent internal organ. This operative code captures complex genitourinary reconstructive work to restore normal urinary tract integrity and resolve pathologic communication between the ureter and nearby organs. Nationally, accurate use of this code matters for appropriate reimbursement, resource allocation, and tracking of surgical management for fistulous complications arising from trauma, prior surgery, infection, or radiation.
Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical procedure tied to the code, typical sites of service, and the service line context. The publication also outlines common modifiers associated with surgical billing, summarizes payer coverage considerations, and provides benchmarking and policy context where available. Data not available in the input is noted where applicable.
This analysis is intended for a national audience of billing specialists, surgical clinicians, and policy analysts seeking a clear reference for coding, clinical context, and payer considerations related to CPT code 50930.
Billing Code Overview
CPT code 50930 describes a surgical procedure to remove a ureterovisceral fistula, an abnormal connection between the ureter and an internal organ near the ureter, with repair of the defect in the involved organ. The service type is a surgical excision and repair of a genitourinary tract fistula. The typical site of service is an inpatient or outpatient surgical setting, commonly performed in an operating room in a hospital or ambulatory surgical center.
Clinical & Coding Specifications
Clinical Context
A 58-year-old female presents with recurrent urinary tract infections, continuous urinary leakage, and imaging that demonstrates an abnormal fistulous tract between the distal ureter and an adjacent pelvic organ (for example, the vagina or sigmoid colon). Conservative management, including antibiotics and urinary diversion, failed to resolve symptoms. The urology team schedules a planned operative repair under general anesthesia. Intraoperative steps commonly include identification and isolation of the ureter, excision of the fistulous tract, and primary repair of the involved visceral organ with layered closure. Ureteral reimplantation or ureteroureterostomy may be performed if segmental ureteral loss is encountered. A ureteral stent is often placed for internal drainage and removed postoperatively. Typical perioperative workflow includes preoperative imaging (CT urogram or retrograde pyelography), anesthesia evaluation, OR time for dissection and repair, placement of drains as indicated, and postoperative monitoring for leakage, infection, and renal function. Usual sites of service are hospital inpatient or outpatient surgical center depending on acuity and complexity. Payors commonly involved in authorization and claims include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or default professional component | When the service is performed in a typical, uncomplicated manner by the reporting practitioner |