CPT® Code 50220

An open nephrectomy, as described by CPT® Code 50220, is a surgical procedure that involves the removal of a kidney along with a partial ureterectomy, which is the surgical excision of a portion of the ureter. This procedure is typically performed through a wide flank incision, which is strategically located just below the lower border of the ribs or near the 11th or 12th rib. In some cases, the 11th and/or 12th ribs may need to be resected to provide adequate access to the kidney. Alternatively, surgeons may opt for an anterior subcostal approach, depending on the specific circumstances of the case. During the procedure, the surgeon carefully exposes the kidney and the ureter, isolating the renal artery and vein for ligation and division. This step is crucial for ensuring that the kidney can be safely removed without excessive bleeding. Once the kidney is freed from its surrounding tissues, a section of the ureter is also excised. This involves meticulously dissecting the affected portion of the ureter, dividing it, and removing it along with the kidney. After the removal, the surgical team takes measures to control any bleeding, places drains if necessary, and finally closes the incisions. It is important to note that if the nephrectomy is complicated by prior surgery on the same kidney, the additional code 50225 should be reported to reflect the complexity of the procedure.