CPT 53250 Bulbourethral Gland Excision Reimbursement | OpenPayer

Summary & Overview

CPT 53250: Excision of Bulbourethral (Cowper's) Glands

CPT code 53250 represents surgical excision of the bulbourethral (Cowper's) glands, a urologic procedure performed for malignancy, symptomatic cysts (Cowper's syringocele), or persistent infection. Nationally, this code captures a niche set of urologic interventions focused on deep perineal gland pathology and is relevant for surgical services billing, facility utilization, and specialty reimbursement discussions. Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise clinical context for the procedure, typical sites of service (hospital operating room or ambulatory surgical center), and the diagnostic imaging commonly associated with preoperative evaluation. The publication also presents national benchmarking and payer coverage considerations where available, highlights coding and reporting considerations relevant to urology and surgical service lines, and summarizes policy updates that affect surgical billing and facility reimbursement for rare gland excisions. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 53250bulbourethral glandCowper's glandurology surgerygenitourinarysurgical excisionambulatory surgeryoperative coding

Billing Code Overview

CPT code 53250 describes surgical excision of the bulbourethral (Cowper's) glands. The bulbourethral glands are paired, pea-sized exocrine glands located at the base of the penis in the deep perineal pouch; they empty into the urethra via a single excretory duct and produce pre-ejaculatory fluid that lubricates and helps neutralize urethral acidity. Indications for excision include malignancy, symptomatic cysts (such as Cowper's syringocele), or refractory infection.

Service type: Surgical excision of glandular tissue (urologic soft-tissue surgery)

Typical site of service: Hospital operating room or ambulatory surgical center, with preoperative imaging or diagnostic studies performed as indicated (for example, retrograde or voiding urethrography, perineal MRI).

Clinical & Coding Specifications

Clinical Context

A 48-year-old male presents with persistent perineal pain, intermittent urethral discharge, and a palpable tender mass at the bulbomembranous urethra. Prior noninvasive evaluation included urinalysis, urine culture, and a pelvic MRI showing a cystic lesion consistent with a Cowper's gland cyst (syringocele). Conservative management failed, and the urologist schedules surgical excision of the bulbourethral (Cowper's) gland for symptomatic relief and definitive diagnosis. The clinical workflow includes preoperative evaluation (history/physical, review of imaging such as retrograde urethrography or perineal MRI), informed consent, anesthesia evaluation (general or regional), operative excision of the gland in the deep perineal pouch with appropriate hemostasis, possible cyst wall biopsy or frozen section if malignancy suspected, catheter placement as indicated, and postoperative monitoring for urinary complications and infection. Pathology review of the excised gland is typical for definitive diagnosis. Typical site of service is an ambulatory surgical center or hospital operating room. Service type: surgical excision of a deep perineal gland (bulbourethral/Cowper's gland) for cyst, infection, or suspected malignancy.

Coding Specifications

Modifier	Description	When to Use
`11`	Office or other outpatient services, initial	Use when the procedure is performed in an outpatient/ASC setting without unusual circumstances and represents the routine service.

CPT 53260: Urethral Polyp Excision or Destruction

CPT-53230-URETHRAL-DIVERTICULECTOMY-VAGINAL-APPROACH

CPT 53230: Urethral Diverticulectomy, Vaginal Approach

CPT-53215-URETHRECTOMY-WITH-VESICOSTOMY-MALE

CPT 53215: Radical Urethrectomy with Vesicostomy for Male Patients

CPT-53240-DIVERTICULUM-INCISION-URINARY-RELIEF

CPT 53240: Incision to Open Urinary Diverticulum

CPT-53235-URETHRAL-DIVERTICULUM-EXCISION-SUPRAPUBIC-APPROACH

CPT 53235: Excision of Male Urethral Diverticulum, Suprapubic Approach

CPT-53270-EXCISION-FULGURATION-SKENE-GLANDS

CPT 53270: Excision or Fulguration of Skene's Glands

CPT-53275-URETHRAL-PROLAPSE-EXCISION-OR-ELECTROSURGERY

CPT 53275: Excision or Electrosurgery for Urethral Prolapse

CPT-53265-URETHRAL-CARUNCLE-EXCISION-DESTRUCTION

CPT 53265: Excision or Destruction of Urethral Caruncle

CPT-53200-URETHRAL-EXCISIONAL-BIOPSY

CPT 53200: Excisional Biopsy of Urethra

CPT-53220-URETHRAL-TUMOR-EXCISION-DESTRUCTION

CPT 53220: Urethral Tumor Excision or Destruction

Showing 1–10 of 11

Taxonomy Code	Specialty	Notes
2084P0800X	Urology	Urologists most commonly perform excision of bulbourethral (Cowper's) glands.
208100000X	General Surgery	General surgeons with urologic experience may perform perineal procedures in some settings.
2080P0207X	Female Pelvic Medicine & Reconstructive Surgery	Listed when pelvic reconstructive surgeons are involved for complex perineal/urethral anatomy (rare).
207RH0000X	Otolaryngology — Head & Neck Surgery	Data not available in the input.
207L00000X	Emergency Medicine	Data not available in the input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N36.8`	Other urethral disorders	Includes focal urethral lesions or obstructive/inflammatory conditions involving periurethral glands such as Cowper's gland pathology.
`N34.1`	Urethritis due to other specified organism	Infection-related inflammation that may involve bulbourethral glands prompting excision if chronic or refractory.
`N48.89`	Other specified disorders of penis	May capture cystic or mass lesions at the bulbous urethra or base of the penis when site-specific codes are lacking.
`N41.9`	Prostatitis, unspecified	Associated pelvic or perineal pain syndromes that can overlap with bulbourethral gland pain and may be part of the differential.
`D49.2`	Neoplasm of uncertain behavior of male genital organs	Used when a gland lesion is suspicious for neoplasm pending pathology; excision indicated for diagnosis.
`R10.2`	Pelvic and perineal pain	Symptom code that can justify surgical intervention when linked to identified gland pathology.
`K68.3`	Perineal abscess	Represents infected collections in the perineum that may involve or arise from the Cowper's glands requiring excision or I&D.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy, with or without collection of specimen(s) by brushing or washing, with or without dilation (separate procedure)	Preoperative diagnostic cystourethroscopy to evaluate urethral pathology or locate Cowper's duct opening prior to excision.
`52005`	Cystourethroscopy, with insertion of indwelling ureteral stent (separate)	May be performed if concomitant urethral or ureteral instrumentation is required during the procedure.
`53210`	Incision and drainage of urethral or periurethral abscess	Performed when infection with abscess formation is present and drainage is required before or during definitive gland excision.
`54220`	Repair of ejaculatory duct (if applicable)	Performed in cases where adjacent ductal structures are involved or require repair during excision.
`88304`	Surgical pathology, gross and microscopic examination	Routine pathology processing and microscopic examination of the excised gland specimen.
`72197`	Magnetic resonance imaging, pelvis; without contrast and with contrast and sagittal, coronal and axial sequences (example pelvic MRI)	Preoperative imaging to delineate gland anatomy and plan operative approach.

OpenPayer