Summary & Overview
CPT 51550: Partial (Simple) Cystectomy for Bladder Resection
CPT code 51550 represents a simple (partial) cystectomy — surgical removal of a portion of the urinary bladder — most frequently used to treat bladder cancer or irreparable bladder damage. This code identifies a definitive surgical intervention with implications for surgical resource use, inpatient or outpatient operating room scheduling, and post-operative care needs. Nationally, procedures coded with CPT 51550 are relevant to surgical oncology, urology, and hospital surgical services planning.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT 51550, typical sites of service, and the common billing environment surrounding partial cystectomy procedures. The publication summarizes benchmark considerations, common billing modifiers encountered in practice, and policy updates that affect payment and prior authorization practices where available. Clinical context highlights indications such as localized bladder malignancy and structural bladder injury, and operational context addresses where the service is delivered and the care team specialties typically involved.
Data not available in the input for associated taxonomies, specific ICD-10 diagnosis pairings, related codes, and detailed payer-specific reimbursement benchmarks are noted as unavailable in the input.
Billing Code Overview
CPT code 51550 describes a simple cystectomy, a surgical procedure to remove part of the urinary bladder. The procedure is most commonly performed to treat bladder cancer or to address significant bladder damage that cannot be managed with conservative measures.
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Service type: Surgical procedure — partial removal of the urinary bladder
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Typical site of service: Operating room in an inpatient or outpatient surgical setting depending on clinical complexity and patient needs
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of gross hematuria and a recent cystoscopic biopsy confirming non-muscle-invasive urothelial carcinoma of the bladder presents for surgical management. Following discussion of options, the urologic surgeon schedules a simple (partial) cystectomy to remove a localized tumor involving the bladder dome. Preoperative workup includes cross-sectional imaging (CT abdomen/pelvis), cardiopulmonary clearance, and urine culture. On the day of surgery the patient undergoes general anesthesia in an operating room at an ambulatory surgical center or hospital outpatient/inpatient setting depending on comorbidities and anticipated need for postoperative observation. The operative workflow includes cystoscopic tumor localization, pelvic exposure, resection of the bladder segment containing the lesion with adequate margins, placement of bladder closure, possible ureteral stent if indicated, and specimen submission to pathology. Postoperative care includes pain control, monitoring for hematuria or urinary leak, bladder catheter management, and coordination of pathology results for potential adjuvant treatment planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, and intensity substantially exceed the typical for 51550 and documentation supports increased complexity. |