CPT® Code 50234

An open nephrectomy with total ureterectomy and bladder cuff excision is a surgical procedure that involves the removal of a kidney along with its associated ureter and a portion of the bladder. This procedure is typically indicated for various renal pathologies, including tumors, severe infections, or other conditions that compromise kidney function. The surgery is performed through a single incision, which can be made in the flank area, just below the lower border of the ribs, or near the 11th or 12th rib. Alternatively, an anterior subcostal approach may be utilized, depending on the surgeon's preference and the patient's anatomy. During the procedure, a Foley catheter is placed to facilitate bladder drainage. The surgical team carefully exposes the kidney and ureter, isolates the renal artery and vein, and then ligates and divides these vessels to allow for the safe removal of the kidney. The ureter is dissected free from surrounding tissues, and a section of the bladder at the ureterovesical junction (UVJ) is excised. The bladder incision is subsequently closed, and measures are taken to control any bleeding, place drains if necessary, and close the incisions. This procedure is coded as CPT® 50234 when performed through a single incision, while CPT® 50236 is used when a separate incision is required for the ureter and bladder cuff removal.