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    v1.0.28
    OpenPayerBilling CodesExcision Procedures on the BladderCPT cpt-51590-radical-cystectomy-with-urinary-diversion
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    CPT 51590: Radical Cystectomy with Urinary Diversion

    Medicare pays $1738 on average nationally for this procedure.

    CPT code 51590 describes a radical cystectomy with urinary diversion, a surgical procedure in which the entire urinary bladder is removed and urinary outflow is reconstructed by creating a ureteroileal conduit or a sigmoid neobladder (U- or J-shaped sigmoid segment) with reimplantation of the ureters and restoration of bowel continuity; service type: major intra-abdominal urologic surgery; typical site of service: inpatient hospital or tertiary surgical center (operating room with postoperative inpatient care).

    For related coverage guidance, see recent payer policy updates: Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults, Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in Adults, Site of Service Ambulatory Service Center (ASC) Select.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 65-year-old male with muscle-invasive bladder carcinoma elected for radical cystectomy with urinary diversion. Preoperative workup includes staging imaging, cystoscopy with biopsy confirming invasive urothelial carcinoma, cardiopulmonary clearance, and bowel preparation. On the day of surgery the patient is admitted to an inpatient operating room setting under general anesthesia. The urologic oncology surgeon performs a radical cystectomy: removal of the urinary bladder and regional lymphadenectomy. To restore urinary drainage, the surgeon constructs an incontinent ileal conduit by isolating a segment of ileum, anastomosing the ureters to the conduit, and maturing a stoma to the abdominal wall, or alternatively constructs a continent diversion such as a sigmoid neobladder and anastomoses it to the urethra when appropriate. Postoperative workflow includes intensive recovery monitoring, stoma care education by nursing and wound ostomy specialists, pain control, early ambulation, ileus management, and discharge planning with follow-up in the urology clinic.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    51590Radical cystectomy with urinary diversion (as described)Primary procedure: removal of the bladder with construction of an ileal conduit or sigmoid neobladder for urinary diversion.
    44120Enterectomy, resection of small intestine; single resection and anastomosisPerformed when isolating an ileal segment for an ileal conduit and restoring bowel continuity.
    50300Cystectomy, partial; wedge resection or other partial cystectomy (separate code for partial procedures)May be performed instead of radical cystectomy for selected localized disease; included as context for alternative bladder procedures.
    38730Lymphadenectomy, open: pelvicPelvic lymph node dissection commonly performed concurrently with radical cystectomy for staging and oncologic control.
    43760Ileostomy, total, diverting loop (temporary)May be performed in selected cases for diversion or protection of bowel anastomosis in complex reconstructions.

    Related Modifiers

    14 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Showing 1–10 of 14

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    2086S0105XSurgery of the Hand (Surgery) PhysicianA surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the up…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    363LF0000XFamily Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    156FC0801XContact Lens FitterAn optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact …
    286500000XMilitary HospitalA health care facility operated by the Department of Defense.
    102L00000XPsychoanalystPsychoanalysis is a comprehensive, theoretical framework which, when applied to a treatment process, consists of an intensive verbal, therapeutic rela…
    176P00000XFuneral DirectorA person, usually an embalmer, whose business is to arrange for the burial or cremation of the dead and to assist at the funeral rites.

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    C67.0Malignant neoplasm of trigone of bladder
    C67.1Malignant neoplasm of dome of bladder
    C67.2Malignant neoplasm of lateral wall of bladder
    C67.3Malignant neoplasm of anterior wall of bladder
    C67.4Malignant neoplasm of posterior wall of bladder
    C67.5Malignant neoplasm of bladder neck
    C67.7Malignant neoplasm of urachus
    C67.8Malignant neoplasm of overlapping sites of bladder
    C67.9Malignant neoplasm of bladder, unspecified
    C79.11Secondary malignant neoplasm of bladder

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01
    Inpatient Surgical Site of ServiceProvidence Health Plan2026-07-01
    Removal of Implantable DevicesBlue Cross Blue Shield - Rhode Island2026-07-01

    Related Codes

    CPT-51500-URACHAL-CYST-SINUS-EXCISION-UMBILICAL-HERNIA-REPAIR

    CPT 51500: Excision of Urachal Cyst or Sinus

    CPT-51520-BLADDER-NECK-EXCISION

    CPT 51520: Excision of Bladder Neck to Relieve Obstruction

    CPT-51525-BLADDER-DIVERTICULECTOMY-OPEN-EXCISION

    CPT 51525: Excision of Bladder Diverticulum

    CPT-51530-BLADDER-TUMOR-EXCISION

    CPT 51530: Excision of Bladder Tumor (Incision into Bladder)

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

    CPT 51535: Ureterocele Excision, Incision, or Repair

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

    CPT 51550: Simple Cystectomy (Partial Bladder Removal)

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

    CPT 51555: Complex Partial Cystectomy

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

    CPT 51565: Bladder Segmental Resection with Ureteral Reimplantation

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

    CPT 51570: Radical Cystectomy (Complete Bladder Removal)

    CPT-51575-RADICAL-CYSTECTOMY-PELVIC-LYMPHADENECTOMY

    CPT 51575: Radical Cystectomy with Pelvic Lymph Node Dissection

    Showing 1–10 of 15

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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