Summary & Overview
CPT 54650: Orchiopexy for Undescended Testicle
CPT code 54650 represents orchiopexy, a urologic surgical procedure to reposition an undescended testicle into the scrotum. The procedure is clinically important as it addresses cryptorchidism, reduces future infertility and malignancy risk, and is commonly performed in pediatric and some adult urology practices. Nationally, orchiopexy accounts for a measurable portion of pediatric urologic operative volume and influences surgical scheduling and facility resource use.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical sites of service, common modifiers associated with surgical billing, and guidance on where to look for related billing and coding details. The publication also highlights benchmark considerations and policy-related updates that commonly affect authorization, bundling with hernia repair, and surgical facility claims processing.
This executive summary prepares clinicians, billing professionals, and policy analysts to understand the clinical purpose of CPT code 54650, typical care settings, and the payer mix relevant to national billing and coverage discussions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 54650 describes orchiopexy, a surgical procedure to move an undescended testicle into the scrotum. The procedure may be performed alone or in conjunction with a hernia repair when an associated inguinal hernia is present.
Service type: Surgical procedure (urologic)
Typical site of service: Hospital operating room or ambulatory surgery center, depending on patient factors and concurrent procedures.
Clinical & Coding Specifications
Clinical Context
A 6-year-old boy presents to pediatric urology with a nonpalpable right testicle noted since birth. Examination and ultrasound confirm an undescended testis in the inguinal canal. The surgical plan is an orchiopexy (CPT 54650) performed under general anesthesia in an ambulatory surgery center. Preoperative steps include informed consent, anesthesia evaluation, and prophylactic antibiotics per facility protocol. Intraoperative workflow: induction of general anesthesia, inguinal incision, mobilization of the spermatic cord, ligation of a patent processus vaginalis if present, creation of a subdartos pouch, and fixation of the testis within the scrotum. If a concurrent inguinal hernia is found, the surgeon repairs the hernia during the same session. Postoperative care includes analgesia, scrotal support, activity restrictions for several days, wound checks in clinic, and documentation of laterality and any complications. Billing captures laterality, any co-procedures (for example, hernia repair), and applicable modifiers for global period or unusual services. Typical site of service is an ambulatory surgery center or hospital outpatient department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right testis |