CPT® Code 50620

An ureterolithotomy is a surgical procedure specifically designed to remove a calculus, commonly referred to as a stone, from the ureter, which is the duct that carries urine from the kidney to the bladder. This procedure is indicated when a stone obstructs the ureter, causing pain, infection, or other complications. The surgery involves making an incision in the abdomen, which may be located over the upper, middle, or lower ureter, depending on the precise location of the stone. During the operation, the abdominal wall muscles are carefully divided, and the peritoneum, the lining of the abdominal cavity, is pushed aside to access the ureter. Once the ureter is identified, it is meticulously dissected free from surrounding tissues, including the serosa and periureteral fat. The surgeon then locates the stone, which may be visually identified by a bulge in the ureter or through manual palpation. To facilitate the removal of the stone, vascular loops are placed above and below it to immobilize the ureter. An incision is made directly over the stone, allowing for its extraction. After the stone is removed, a catheter is inserted into the ureter for irrigation, ensuring that any remaining fragments are cleared. A drainage tube, such as a soft Penrose or suction tube, is then placed to facilitate drainage from the ureter. The ureter incision is carefully closed to avoid constriction, and the abdominal incision is closed around the drainage tube. This procedure is categorized under CPT® Code 50620, which specifically refers to the removal of stones from the middle one-third of the ureter, distinguishing it from similar procedures for the upper and lower segments of the ureter.