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CPT®
39502

CPT® Code 39502
Deleted

Official Description

Repair, paraesophageal hiatus hernia, transabdominal, with or without fundoplasty, vagotomy, and/or pyloroplasty, except neonatal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Paraesophageal hiatal hernias are a type of hernia that occurs when a portion of the stomach, specifically the fundus, protrudes into the thoracic cavity through an opening in the diaphragm known as the hiatus. This condition typically manifests anterior or lateral to the esophagus. The surgical procedure associated with CPT® Code 39502 involves a transabdominal approach to repair the hernia. During this operation, an incision is made in the upper abdomen to gain access to the lower esophagus, stomach, and duodenum. The lower esophagus is carefully mobilized to reach the gastroesophageal junction, allowing for the fundus of the stomach to be gently pulled back into its proper position within the abdominal cavity. In some cases, a fundoplasty may be performed, which involves suturing the fundus around the esophagus to reinforce the junction and prevent future herniation. Additionally, the procedure may include a vagotomy, which is the surgical cutting of the vagus nerve, and/or a pyloroplasty, which is a surgical procedure to widen the pylorus, the opening from the stomach into the duodenum. The diaphragm defect is then repaired to restore normal anatomical function. This procedure is not performed on neonates, indicating that it is intended for older children and adults who present with this type of hernia.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Paraesophageal hiatal hernia repair is indicated for patients presenting with specific symptoms or conditions associated with this type of hernia. The following are the explicitly provided indications for performing this procedure:

  • Symptoms of Herniation Patients may experience symptoms such as chest pain, difficulty swallowing, or gastroesophageal reflux due to the herniation of the stomach fundus.
  • Complications The procedure is indicated in cases where complications arise from the hernia, such as strangulation or obstruction of the stomach.
  • Pyloric Stenosis If the patient has pyloric stenosis, characterized by a narrowing of the pylorus, this procedure may be necessary to alleviate the condition.

2. Procedure

The surgical procedure for repairing a paraesophageal hiatal hernia involves several critical steps, which are detailed as follows:

  • Step 1: Incision An incision is made in the upper abdomen to provide access to the abdominal cavity. This allows the surgeon to visualize and manipulate the lower esophagus, stomach, and duodenum effectively.
  • Step 2: Mobilization of the Lower Esophagus The lower esophagus is carefully mobilized to the level of the gastroesophageal junction. This step is crucial for ensuring that the esophagus can be properly positioned and that the herniated fundus can be addressed.
  • Step 3: Reduction of the Fundus The fundus of the stomach, which has herniated into the thoracic cavity, is gently reduced back into the abdominal cavity. This is typically achieved using gentle traction to avoid any trauma to the surrounding tissues.
  • Step 4: Fundoplasty (if applicable) In some cases, the fundus may be sutured around the esophagus at the gastroesophageal junction to create a fundoplasty. This step helps to reinforce the junction and prevent future herniation.
  • Step 5: Vagotomy (if applicable) If indicated, a vagotomy may be performed, which involves severing the vagus nerve to reduce gastric secretions and motility, thereby addressing any related complications.
  • Step 6: Pyloroplasty (if applicable) If the patient has pyloric stenosis, the pyloric canal and adjacent duodenum are incised longitudinally and then closed transversely. This creates a wider opening between the stomach and duodenum, facilitating better gastric drainage.
  • Step 7: Diaphragm Repair Finally, the defect in the diaphragm is repaired to restore normal anatomical integrity and function, ensuring that the hernia does not recur.

3. Post-Procedure

After the completion of the paraesophageal hiatal hernia repair, patients typically require monitoring for any immediate complications. Post-procedure care may include pain management, dietary modifications, and gradual resumption of normal activities. Patients are often advised to avoid heavy lifting and strenuous activities for a specified period to allow for proper healing. Follow-up appointments are essential to assess recovery and ensure that the hernia repair is successful. Any signs of complications, such as persistent pain, difficulty swallowing, or gastrointestinal distress, should be reported to the healthcare provider promptly.
Short Descr REPAIR PARAESOPHAGEAL HERNIA
Medium Descr RPR PARAESOPHGL HIATUS HRNA TABDL
Long Descr Repair, paraesophageal hiatus hernia, transabdominal, with or without fundoplasty, vagotomy, and/or pyloroplasty, except neonatal
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 86 - Other hernia repair
Date
Action
Notes
2011-01-01 Deleted Deleted
Pre-1990 Added Code added.
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Description
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Description
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