2025 CPT code 50075
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy).
Modifiers 50 (bilateral procedure) and other modifiers may be applicable depending on the specific circumstances of the case (e.g., anesthesia modifiers, complication modifiers).
The medical necessity for 50075 is established by the presence of a symptomatic large staghorn calculus causing obstruction, pain, infection, or renal damage.Conservative management (e.g., lithotripsy) has failed or is not feasible due to the stone's size and complexity.Open surgical removal is medically necessary to alleviate symptoms and prevent further complications.
The urologist or surgeon is responsible for performing the entire procedure, including incision, dissection, stone removal, and closure.Anesthesiologists or CRNAs manage anesthesia.Nursing staff assist with patient positioning, monitoring, and wound care.
In simple words: The doctor removes a large, branched kidney stone that fills the kidney's collecting system through an incision in the kidney. This may involve special techniques to see and reach the stone, and a tube might be placed to drain the kidney after the surgery.
This CPT code, 50075, describes a nephrolithotomy, specifically the surgical removal of a large staghorn calculus (a branched kidney stone often composed of struvite) that fills the renal pelvis and calyces.The procedure may involve an anatrophic pyelolithotomy, requiring entry into the kidney parenchyma, methylene blue dye injection for visualization, and potential renal vessel cooling to induce temporary ischemia.Post-procedure, a nephrostomy tube is typically placed for drainage.The procedure includes incision, dissection, extraction of the calculus, and layered closure of the incision.
Example 1: A 60-year-old female presents with severe flank pain and hematuria. Imaging reveals a large staghorn calculus filling the right renal pelvis and calyces.Open nephrolithotomy with anatrophic pyelolithotomy is performed to remove the stone., A 45-year-old male with a history of recurrent UTIs and kidney stones presents with right flank pain and fever. Imaging shows a large, complex staghorn calculus.Open surgery is required, and 50075 is reported., A 72-year-old female with a history of kidney stones undergoes an open nephrolithotomy to remove a large staghorn calculus. The procedure is complicated by significant bleeding and requires blood transfusion.50075 is billed with appropriate modifiers for the complexity and complications.
Preoperative imaging (KUB, CT scan) showing the stone's location and size; operative report detailing the approach, technique, complications, and findings; pathology report confirming stone composition; post-operative imaging (if done); and notes documenting nephrostomy tube placement and removal.
** This code may be used for open surgical approaches to staghorn calculus removal.Percutaneous approaches are typically coded using 50080 or 50081.Always verify the exact nature of the procedure performed and document thoroughly to support the code selection.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable; 50075 is a comprehensive code that encompasses all components of the procedure.
- Fee Schedule: Historical fee schedule data can vary based on payer and location.Refer to historical fee schedule databases for specific information.
- Specialties:Urology, Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center