Summary & Overview
CPT 53515: Suturing of Prostatomembranous Urethral Wound
CPT code 53515 designates surgical suturing of a urethral wound or injury in the prostatomembranous region, a focused genitourinary procedure addressing damage to the segment of urethra between the prostate and the bulb of the penis. This code is used to report operative repair of traumatic or iatrogenic urethral disruption in adult male patients and is relevant where specialized urologic surgical care is required. Nationally, accurate reporting of CPT code 53515 matters for procedure tracking, clinical quality measurement, and appropriate payment for anatomic urethral repairs.
Key payers included in the discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when this procedure is reported, typical sites of service, and the common payer landscape that covers such urologic surgeries. The publication outlines benchmarks and coverage themes relevant to this procedure, highlights coding and billing considerations where available, and situates the code within procedural categories used for operative genitourinary care. Data not available in the input will be noted where specific benchmarks, modifiers usage patterns, diagnosis mappings, or payer-specific policies are absent.
Billing Code Overview
CPT code 53515 describes suturing (stitching) of a urethral wound or injury in the prostatomembranous region, the portion of the male urethra that passes from the prostate to the bulb of the penis. This procedure is a surgical repair of urethral trauma localized to the prostatomembranous urethra.
Service Type: Urethral repair / genitourinary surgery
Typical Site of Service: Operating room or ambulatory surgical facility
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the emergency department after a perineal straddle injury sustained during a bicycle accident. He has blood at the urethral meatus, inability to void, and suprapubic fullness. Initial evaluation includes focused genitourinary exam, retrograde urethrogram to localize urethral disruption, and bladder decompression as needed. Imaging demonstrates a partial laceration of the prostatomembranous urethra. The patient is taken to the operating room for repair. Under general anesthesia, the urologist performs primary surgical exploration and stitching (repair) of the prostatomembranous urethral wound (CPT 53515). A suprapubic catheter may be placed for urinary diversion while the urethra heals. Postoperative workflow includes catheter management, antibiotics, pain control, and scheduled follow-up with repeat urethrogram to confirm healing before removing the suprapubic catheter or urethral catheter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and complexity substantially exceed usual for CPT 53515. Documentation must justify additional payment. |