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CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

CPT code 51500 represents the surgical excision of a urachal cyst or sinus and may include concurrent repair of an umbilical hernia. This procedure addresses a congenital or acquired tract between the bladder and umbilicus that can cause infection, drainage, or other complications. Nationally, accurate coding for this operation matters for surgical quality measurement, appropriate reimbursement, and billing consistency across hospitals and ambulatory surgical centers. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for 51500, guidance on typical sites of service and service type, and an outline of what to expect in payer coverage practices and benchmarking. The publication summarizes common modifiers used with surgical procedures, highlights relevant coding considerations, and identifies areas where policy updates or payer-specific rules may affect claims processing. The content is designed for coding professionals, surgical administrators, and policy analysts seeking a clear national overview of how CPT code 51500 is applied and documented in clinical and billing workflows. Data not available in the input will be identified where applicable.

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Billing Code Overview

CPT code 51500 describes the surgical excision of a urachal cyst or sinus, which involves removal of an abnormal connection between the urinary bladder and the umbilicus. The procedure may also include surgical correction of an umbilical hernia when performed during the same operative session.

Service Type: Surgical—Urologic/General Surgery

Typical Site of Service: Operating room or ambulatory surgical center, with postoperative recovery in an outpatient or inpatient setting depending on patient condition and concurrent procedures.

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CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

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Get alerted when payer policies referencing 51500 are released or updated.

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Billing Code Overview

Service Type: Surgical—Urologic/General Surgery

Typical Site of Service: Operating room or ambulatory surgical center, with postoperative recovery in an outpatient or inpatient setting depending on patient condition and concurrent procedures.

Clinical & Coding Specifications

Clinical Context

A typical patient is a child or young adult presenting with a midline umbilical mass, recurrent periumbilical drainage, localized pain, or signs of infection. The surgical team evaluates history and performs a focused exam noting an umbilical sinus or palpable cystic structure tracking toward the bladder. Preoperative imaging (ultrasound or CT) defines the tract and rules out bladder involvement. The workflow includes preoperative consent, perioperative antibiotics as indicated, general anesthesia, and a lower midline or periumbilical incision. The surgeon excises the urachal cyst or sinus en bloc; if an umbilical hernia is present, simultaneous hernia repair may be performed. Specimens are sent for pathology and cultures when infected. Postoperative care includes wound management, analgesia, and follow-up to monitor healing and rule out recurrence or infection. Typical sites of service are the hospital operating room or ambulatory surgery center depending on patient age, comorbidity, and procedure complexity. Common payors encountered for authorization and billing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work or time substantially exceeds typical for `51500` due to extensive dissection or infection.
`23`	Unusual anesthesia	When general anesthesia is required for an ordinarily local/regional procedure because of patient condition.
`50`	Bilateral procedure	Not typically applicable to `51500` but used if bilateral concurrent abdominal wall repairs are billed.
`51`	Multiple procedures	When `51500` is billed with additional distinct procedures during the same operative session.
`52`	Reduced services	When a partially performed excision is billed due to intraoperative findings preventing completion.
`53`	Discontinued procedure	If the operation is aborted for patient safety before substantial work is performed.
`62`	Two surgeons	When two surgeons of differing specialties perform distinct portions of the excision concurrently.
`76`	Repeat procedure by same physician	(Not in provided list) Data not available in the input.
`78`	Unplanned return to OR	When the patient returns to the operating room for a complication related to the original `51500` procedure.
`80`	Assistant surgeon	When a surgical assistant participates and payer requires the modifier for reimbursement.
`81`	Minimum assistant surgeon	When minimal assistance is provided and the payer recognizes this modifier.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When a certified assistant from these professions performed part of the procedure per payer policy.
`26`	Professional component	Rarely used for `51500`; would apply only if a bill includes a separable professional component for interpretation services.
`TC`	Technical component	Rarely applicable; used only if technical component is billed separately for facility charges.

Taxonomy Code	Specialty	Notes
`2080S0000X`	General Surgery	Most common specialty performing urachal cyst/sinus excision.
`2080P0220X`	Pediatric Surgery	Common when the patient is a child or adolescent.
`207L00000X`	Urology	Involved when bladder or urinary tract connection is suspected or confirmed.
`207T00000X`	Colon and Rectal Surgery	Occasionally involved for complex lower midline or concurrent abdominal wall pathology.
`208D00000X`	Obstetrics & Gynecology	May be involved for adult female patients with adjacent gynecologic pathology.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N32.89`	Other specified disorders of bladder	May be used when bladder involvement or abnormal connection from a urachus is suspected.
`K42.9`	Umbilical hernia without obstruction or gangrene	Common concurrent diagnosis when umbilical hernia repair is performed with `51500`.
`K38.9`	Disorder of umbilicus, unspecified	Used for symptomatic umbilical sinus or draining umbilicus when a more specific code is not available.
`A49.9`	Bacterial infection, unspecified	Applied when the urachal cyst presents with local infection without organism specified.
`R10.9`	Unspecified abdominal pain	May be used when the primary complaint is nonspecific abdominal or periumbilical pain leading to discovery of a urachal remnant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair of superficial wound, intermediate closure, 2.5 cm to 7.5 cm	May be used for layered closure of the skin and subcutaneous tissue after excision of a small urachal cyst.
`49495`	Re-exploration of stoma, not included elsewhere	Data not directly applicable; Data not available in the input.
`49585`	Repair of umbilical hernia, reducible, age 5 years or older	Commonly performed concurrently when an umbilical hernia is identified during `51500` and requires repair.
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy	May be used when intra-abdominal exploration beyond a localized excision is required due to extensive tract or complications.
`49010`	Laparotomy with exploration, or peritoneal drainage	Used if peritoneal contamination is addressed during the same operative session.
`77021`	Ultrasound guidance for diagnostic or therapeutic procedures	Preoperative ultrasound for localization of the urachal tract or cyst (diagnostic imaging) — note imaging codes are billed separately by radiology.

Note: For any CPT code listed above, apply appropriate modifiers and payer-specific billing rules from Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare when submitting claims.

Related Codes

CPT-51520-BLADDER-NECK-EXCISION

CPT 51520: Excision of Bladder Neck to Relieve Obstruction

CPT-51525-BLADDER-DIVERTICULECTOMY-OPEN-EXCISION

CPT 51525: Open Excision of Bladder Diverticulum

CPT-51530-BLADDER-TUMOR-EXCISION

CPT 51530: Incision for Removal of Bladder Tumor

CPT-51535-URETEROCELE-EXCISION-REPAIR-BLADDER-INCISION

CPT 51535: Ureterocele Excision or Repair via Bladder Incision

CPT-51550-PARTIAL-CYSTECTOMY-SIMPLE-CYSTECTOMY-BLADDER-RESECTION

CPT 51550: Partial (Simple) Cystectomy for Bladder Resection

CPT-51555-COMPLEX-PARTIAL-CYSTECTOMY-BLADDER-RESECTION

CPT 51555: Complex Partial Cystectomy for Bladder Resection

CPT-51565-BLADDER-RESECTION-AND-URETERAL-REIMPLANTATION

CPT 51565: Bladder Resection with Ureteral Reimplantation

CPT-51570-RADICAL-CYSTECTOMY-COMPLETE-BLADDER-REMOVAL

CPT 51570: Radical Cystectomy, Complete Urinary Bladder Removal

CPT-51575-RADICAL-CYSTECTOMY-PELVIC-LYMPHADENECTOMY

CPT 51575: Radical Cystectomy with Pelvic Lymph Node Dissection

CPT-51580-RADICAL-CYSTECTOMY-WITH-URINARY-DIVERSION

CPT 51580: Radical Cystectomy with Urinary Diversion

Showing 1–10 of 15

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work or time substantially exceeds typical for `51500` due to extensive dissection or infection.
`23`	Unusual anesthesia	When general anesthesia is required for an ordinarily local/regional procedure because of patient condition.
`50`	Bilateral procedure	Not typically applicable to `51500` but used if bilateral concurrent abdominal wall repairs are billed.
`51`	Multiple procedures	When `51500` is billed with additional distinct procedures during the same operative session.
`52`	Reduced services	When a partially performed excision is billed due to intraoperative findings preventing completion.
`53`	Discontinued procedure	If the operation is aborted for patient safety before substantial work is performed.
`62`	Two surgeons	When two surgeons of differing specialties perform distinct portions of the excision concurrently.
`76`	Repeat procedure by same physician	(Not in provided list) Data not available in the input.
`78`	Unplanned return to OR	When the patient returns to the operating room for a complication related to the original `51500` procedure.
`80`	Assistant surgeon	When a surgical assistant participates and payer requires the modifier for reimbursement.
`81`	Minimum assistant surgeon	When minimal assistance is provided and the payer recognizes this modifier.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When a certified assistant from these professions performed part of the procedure per payer policy.
`26`	Professional component	Rarely used for `51500`; would apply only if a bill includes a separable professional component for interpretation services.
`TC`	Technical component	Rarely applicable; used only if technical component is billed separately for facility charges.

Taxonomy Code	Specialty	Notes
`2080S0000X`	General Surgery	Most common specialty performing urachal cyst/sinus excision.
`2080P0220X`	Pediatric Surgery	Common when the patient is a child or adolescent.
`207L00000X`	Urology	Involved when bladder or urinary tract connection is suspected or confirmed.
`207T00000X`	Colon and Rectal Surgery	Occasionally involved for complex lower midline or concurrent abdominal wall pathology.
`208D00000X`	Obstetrics & Gynecology	May be involved for adult female patients with adjacent gynecologic pathology.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N32.89`	Other specified disorders of bladder	May be used when bladder involvement or abnormal connection from a urachus is suspected.
`K42.9`	Umbilical hernia without obstruction or gangrene	Common concurrent diagnosis when umbilical hernia repair is performed with `51500`.
`K38.9`	Disorder of umbilicus, unspecified	Used for symptomatic umbilical sinus or draining umbilicus when a more specific code is not available.
`A49.9`	Bacterial infection, unspecified	Applied when the urachal cyst presents with local infection without organism specified.
`R10.9`	Unspecified abdominal pain	May be used when the primary complaint is nonspecific abdominal or periumbilical pain leading to discovery of a urachal remnant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair of superficial wound, intermediate closure, 2.5 cm to 7.5 cm	May be used for layered closure of the skin and subcutaneous tissue after excision of a small urachal cyst.
`49495`	Re-exploration of stoma, not included elsewhere	Data not directly applicable; Data not available in the input.
`49585`	Repair of umbilical hernia, reducible, age 5 years or older	Commonly performed concurrently when an umbilical hernia is identified during `51500` and requires repair.
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy	May be used when intra-abdominal exploration beyond a localized excision is required due to extensive tract or complications.
`49010`	Laparotomy with exploration, or peritoneal drainage	Used if peritoneal contamination is addressed during the same operative session.
`77021`	Ultrasound guidance for diagnostic or therapeutic procedures	Preoperative ultrasound for localization of the urachal tract or cyst (diagnostic imaging) — note imaging codes are billed separately by radiology.

Related Codes

CPT-51520-BLADDER-NECK-EXCISION

CPT 51520: Excision of Bladder Neck to Relieve Obstruction

CPT-51525-BLADDER-DIVERTICULECTOMY-OPEN-EXCISION

CPT 51525: Open Excision of Bladder Diverticulum

CPT-51530-BLADDER-TUMOR-EXCISION

CPT 51530: Incision for Removal of Bladder Tumor

CPT-51535-URETEROCELE-EXCISION-REPAIR-BLADDER-INCISION

CPT 51535: Ureterocele Excision or Repair via Bladder Incision

CPT-51550-PARTIAL-CYSTECTOMY-SIMPLE-CYSTECTOMY-BLADDER-RESECTION

CPT 51550: Partial (Simple) Cystectomy for Bladder Resection

CPT-51555-COMPLEX-PARTIAL-CYSTECTOMY-BLADDER-RESECTION

CPT 51555: Complex Partial Cystectomy for Bladder Resection

CPT-51565-BLADDER-RESECTION-AND-URETERAL-REIMPLANTATION

CPT 51565: Bladder Resection with Ureteral Reimplantation

CPT-51570-RADICAL-CYSTECTOMY-COMPLETE-BLADDER-REMOVAL

CPT 51570: Radical Cystectomy, Complete Urinary Bladder Removal

CPT-51575-RADICAL-CYSTECTOMY-PELVIC-LYMPHADENECTOMY

CPT 51575: Radical Cystectomy with Pelvic Lymph Node Dissection

CPT-51580-RADICAL-CYSTECTOMY-WITH-URINARY-DIVERSION

CPT 51580: Radical Cystectomy with Urinary Diversion

Showing 1–10 of 15

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

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CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

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Billing Code Overview

CPT 51500: Excision of Urachal Cyst or Sinus, ± Umbilical Hernia Repair

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What exactly does CPT 51500 cover and where is this procedure typically performed?

Which specialties perform CPT 51500?

Which CPT modifiers are commonly used with 51500 and how should they be applied?

What related CPT codes should coders consider when billing with 51500?

Which diagnosis codes are commonly billed with CPT 51500?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What exactly does CPT 51500 cover and where is this procedure typically performed?

Which specialties perform CPT 51500?

Which CPT modifiers are commonly used with 51500 and how should they be applied?

What related CPT codes should coders consider when billing with 51500?

Which diagnosis codes are commonly billed with CPT 51500?

References