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Official Description

Excision or unroofing of cyst(s) of kidney

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 50280 involves the surgical treatment of one or more cysts located in the kidney. This is achieved through either excision or unroofing of the cysts. In this surgical intervention, a wide incision is made in the flank area, which allows the surgeon to access and expose the affected kidney. Once the kidney is visible, the cyst is opened to allow for the drainage of its fluid content. Following this, the cyst wall, which may be redundant, is completely excised using both blunt and sharp dissection techniques. To prevent the recurrence of the cyst, the base of the cyst is fulgurated, a process that involves the application of heat to destroy tissue. After the cyst has been addressed, the defect left behind is filled with perirenal fat to aid in healing. Alternatively, if an unroofing procedure is performed, the surgeon creates a window in the cyst wall or partially removes it, followed by marsupialization, which results in an open pocket formed by the remaining cyst wall. In some cases, drains may be inserted into the created window to facilitate ongoing drainage, and the remaining cyst wall is then closed around these drains. Throughout the procedure, careful attention is given to controlling any bleeding, and the surgical incisions are subsequently closed to complete the operation.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 50280 is indicated for the treatment of cysts in the kidney that may cause symptoms or complications. The following conditions may warrant this surgical intervention:

  • Symptomatic renal cysts Cysts that lead to pain, discomfort, or other symptoms necessitating surgical intervention.
  • Complicated cysts Cysts that are infected, hemorrhagic, or causing obstruction to urinary flow.
  • Large cysts Cysts that are significantly sized and may pose a risk of rupture or other complications.

2. Procedure

The procedure for excision or unroofing of kidney cysts involves several critical steps, each aimed at effectively treating the cyst while minimizing complications.

  • Step 1: Incision A wide flank incision is made over the affected kidney to provide adequate access. This incision allows the surgeon to expose the kidney fully, ensuring that the cyst can be treated effectively.
  • Step 2: Cyst Exposure Once the kidney is exposed, the surgeon identifies the cyst or cysts that require treatment. This step is crucial for determining the appropriate surgical approach.
  • Step 3: Cyst Opening and Drainage The cyst is then opened, allowing the fluid within to be drained. This step alleviates pressure and symptoms associated with the cyst.
  • Step 4: Cyst Wall Excision The redundant cyst wall is excised in its entirety using both blunt and sharp dissection techniques. This thorough removal is essential to prevent recurrence of the cyst.
  • Step 5: Fulguration The base of the cyst is fulgurated to destroy any remaining tissue that could lead to recurrence. This step is critical in ensuring the long-term success of the procedure.
  • Step 6: Filling the Defect After the cyst wall is removed, the defect is filled with perirenal fat. This helps to promote healing and maintain the integrity of the kidney structure.
  • Step 7: Unroofing Option If an unroofing procedure is chosen, a window is created in the cyst wall or a portion of the cyst wall is resected. The remaining cyst wall is then marsupialized, creating an open pocket.
  • Step 8: Drain Placement In cases where unroofing is performed, drains may be placed in the window to facilitate ongoing drainage of any fluid. This helps to prevent fluid accumulation post-operatively.
  • Step 9: Closure The remaining cyst wall is closed around the drains, and any bleeding is controlled. Finally, the incisions made during the procedure are closed to complete the operation.

3. Post-Procedure

After the procedure, patients may require monitoring for any signs of complications, such as bleeding or infection. The placement of drains, if applicable, will facilitate the drainage of any residual fluid and should be monitored for proper function. Patients can expect a recovery period during which they may experience some discomfort or pain at the incision site. Follow-up appointments will be necessary to assess healing and ensure that the cyst has not recurred. Instructions regarding activity restrictions and wound care will be provided to support optimal recovery.

Short Descr EXC/UNROOFING CYST KIDNEY
Medium Descr EXCISION/UNROOFING CYST KIDNEY
Long Descr Excision or unroofing of cyst(s) of kidney
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) 1 - 150% payment adjustment for bilateral procedures applies.
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) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 112 - Other OR therapeutic procedures of urinary tract
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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