2025 CPT code 50750
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Ureterocalycostomy: surgical connection of the ureter to the renal calyx for urinary drainage.
Modifiers may be applicable depending on the circumstances.For example, modifier 50 (bilateral procedure) if performed on both ureters, modifier 59 (distinct procedural service) if additional services were performed, or other modifiers may be necessary based on individual patient circumstances.
Medical necessity for ureterocalycostomy is established when conservative management fails to alleviate UPJO symptoms (e.g., recurrent UTIs, hydronephrosis, impaired renal function), and other surgical options (e.g., pyeloplasty) are not feasible due to anatomical constraints (e.g., extensive scarring, short ureter).
The urologist performs the ureterocalycostomy, managing all aspects from preoperative preparation and anesthesia to incision, dissection, anastomosis, stent placement, drainage tube insertion, and wound closure. Postoperative care and monitoring of urine output are also part of the clinical responsibility.
In simple words: Ureterocalycostomy is surgery to fix a blockage in the tube (ureter) that carries urine from the kidney to the bladder.The surgeon connects the ureter to a part of the kidney (renal calyx) to create a new pathway for urine to flow.
Ureterocalycostomy is a surgical procedure where the upper pole of a healthy, non-dilated ureter is anastomosed to a renal calyx to redirect urinary drainage. This is typically performed to bypass a ureteropelvic junction obstruction (UPJO) or blockage in the upper ureter, restoring the continuity of the upper urinary tract.The procedure involves accessing the ureter and calyx (often requiring abdominal incision and potentially rib resection), dissecting through subcutaneous tissue, separating the ureter from fibrotic or strictured areas, exposing and incising the renal calyx parenchyma. A stent is then placed, creating a tension-free connection between the upper ureter and lower calyx. The connection is sutured, the area is closed, and drainage tubes (abdominal and bladder catheter) are inserted for urine monitoring. Finally, the skin incision is closed.
Example 1: A patient with a long-standing UPJO and significant peripelvic scarring undergoes ureterocalycostomy after failed pyeloplasty attempts.The surgeon creates a new drainage pathway by connecting the ureter to a renal calyx., A patient with a solitary kidney and a complex UPJO obstruction requiring surgical intervention undergoes ureterocalycostomy as a salvage procedure to prevent nephrectomy., A pediatric patient with UPJO due to congenital anomaly presents with recurrent urinary tract infections; ureterocalycostomy is performed to establish free urinary flow.
Preoperative imaging (e.g., CT urogram, IVP) demonstrating UPJO, operative report detailing the surgical technique, including stent placement and type, postoperative imaging (e.g., renal ultrasound) to confirm patency of the anastomosis, and pathology report if tissue is sent for analysis.Complete patient history and physical exam documentation, including the medical necessity for the procedure.
** Ureterocalycostomy is considered a salvage procedure, often used when other surgical options for UPJO have failed or are not feasible.The procedure requires a high level of surgical skill and precision.Postoperative monitoring is essential to ensure successful urinary drainage and to identify any complications early.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:Urology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center