CPT® Code 50240

An open partial nephrectomy, as described by CPT® Code 50240, is a surgical procedure aimed at removing a portion of the kidney while preserving the remaining healthy tissue. This procedure is typically indicated for patients with localized kidney tumors or lesions that necessitate removal without the need for a complete nephrectomy, which would involve the removal of the entire kidney. The surgery begins with a wide flank incision made just below the lower border of the ribs, allowing the surgeon to access the kidney effectively. Alternatively, an anterior subcostal approach may be employed, depending on the specific circumstances and the surgeon's preference. During the operation, careful attention is given to the kidney's vasculature to ensure that blood supply to the remaining kidney tissue is maintained. The renal artery is isolated, and a vascular loop is placed to control blood flow during the procedure. The surrounding perirenal fat is meticulously dissected away from the kidney to expose the lesion. Small lesions can be enucleated and excised using both blunt and sharp dissection techniques, while larger lesions may require additional measures such as diuresis, temporary occlusion of the renal artery supplying the tumor site, and renal hypothermia to minimize blood loss and protect the kidney's function. After the renal mass is resected, any bleeding is controlled through suture-ligation of the affected arteries and veins, and the parenchymal defect in the kidney is subsequently closed to restore the integrity of the organ.