CPT® Code 50340

The procedure described by CPT® Code 50340 refers to a recipient nephrectomy, which is a surgical operation performed to remove a kidney from a donor recipient prior to the transplantation of a new kidney. This operation is classified as a separate procedure, indicating that it is distinct from the transplantation itself. The nephrectomy is typically performed through a wide flank incision, which is strategically made just below the lower border of the ribs or near the 11th or 12th rib. In some cases, an anterior subcostal approach may be utilized, depending on the specific circumstances and the surgeon's preference. During the procedure, the peritoneum, which is the membrane lining the abdominal cavity, is mobilized to allow visualization of the anterior surface of the kidney. The colon is then mobilized and moved medially to provide better access to the kidney. Key anatomical structures, such as the colorenal ligaments, are divided to expose Gerota's fascia, which is the connective tissue surrounding the kidney. The ureter, which is the duct that carries urine from the kidney to the bladder, along with the surrounding vascular structures, is identified and retracted to facilitate access to the renal hilum—the area where the renal artery and vein enter and exit the kidney. The procedure involves careful dissection to ensure that the kidney is removed without damaging surrounding tissues or blood vessels. The renal vein is exposed, and the gonadal, lumbar, and adrenal veins are clipped and divided to free the kidney. The renal artery is also identified and dissected from surrounding tissues. To prevent torsion of the kidney and potential damage to its vascular supply, certain attachments are left intact during the dissection. The ureter is carefully dissected and divided at the level of the iliac vessels, and the kidney is ultimately removed after being freed from its remaining attachments. The procedure concludes with the closure of the ureter, control of any bleeding, placement of drains if necessary, and closure of the incisions made during the surgery.