Summary & Overview
CPT 53446: Removal of Inflatable Artificial Urinary Sphincter
CPT code 53446 covers surgical removal of an implanted inflatable artificial urinary sphincter when the device fails to resolve urinary incontinence or must be explanted for infection or erosion. This code is relevant nationally for urology practices, surgical centers, and hospitals because explantation is a definitive treatment step with implications for post‑operative care, device replacement planning, and payer coverage determinations.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical scenario the code represents, typical sites of service, and common billing considerations tied to explantation procedures. The publication summarizes benchmarks and payment context where available, outlines clinical indications that commonly lead to use of the code, and highlights policy or coding updates that affect national billing practice. If specific payer policies, reimbursement rates, or associated diagnosis codes are not provided in the input, those items are noted as not available.
Billing Code Overview
CPT code 53446 describes the removal of an inflatable artificial urinary sphincter when the device fails to control urinary incontinence or must be removed because of infection or erosion. This procedure is a surgical explantation of the entire sphincter system.
-
Service type: Surgical removal of an implanted urologic device
-
Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a man with persistent moderate-to-severe stress urinary incontinence after radical prostatectomy who previously had placement of an inflatable artificial urinary sphincter (AUS) but continues to have leakage or develops complications. The patient presents to a urology clinic with symptoms of recurrent incontinence, pain, urinary urgency, or device malfunction. Evaluation includes history, focused genitourinary exam, urinalysis and urine culture to assess infection, and device interrogation or imaging if erosion or mechanical failure is suspected. When conservative measures are ineffective or infection/erosion is identified, the urologist schedules removal of the inflatable AUS in an operating room under general or regional anesthesia. The procedure involves surgical exposure of the pump, tubing, and cuff, explantation of all device components, irrigation and debridement if infected, and wound closure. Postoperative care includes antibiotics if infection was present, pain control, wound monitoring, and discussion of future continence options. Typical site of service is the hospital operating room or ambulatory surgical center depending on case complexity and patient comorbidities. Common clinical reasons for removal include device infection, cuff or pump erosion, persistent incontinence due to device failure, or patient preference for device removal.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician's professional service distinct from technical facility charges. |