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Official Description

Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

An ectopic ureterectomy is a surgical procedure that involves the complete removal of an ectopic ureter, which is a ureter that does not connect normally to the bladder and instead terminates in an abnormal location. This condition can occur in both males and females, with the ureter potentially ending in various structures such as the epididymis, vas deferens, ejaculatory duct, seminal vesicle, urethra, or utriculus in males, and in females, it may terminate in the Gartner's duct, upper vagina, cervix, uterus, or urethra. In rare cases, the ectopic ureter may even terminate in the rectum for both sexes. The procedure is performed using a combination of abdominal, vaginal, and/or perineal approaches to ensure complete excision of the ureter. Prior to the surgical intervention, a Foley catheter is typically placed to drain the bladder, facilitating better access to the ureter during the operation. The surgical process begins with an incision in the abdomen to expose and inspect the ureter, followed by a possible additional incision in the vagina or perineum at the site of the ureter's abnormal termination, ultimately leading to the excision of the ectopic ureter.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of total ureterectomy for an ectopic ureter is indicated in specific clinical scenarios where the ureter is not functioning properly due to its abnormal termination. The following conditions may warrant this surgical intervention:

  • Ectopic Ureter Presence The presence of an ectopic ureter that terminates in an abnormal anatomical location, which may lead to complications such as urinary incontinence or recurrent urinary tract infections.
  • Urinary Tract Infections Recurrent urinary tract infections that are associated with the ectopic ureter, indicating that the abnormal ureteral termination is contributing to the patient's symptoms.
  • Urinary Obstruction Symptoms of urinary obstruction or other functional impairments caused by the ectopic ureter's abnormal position.
  • Associated Anomalies The presence of other urinary tract anomalies that may necessitate the removal of the ectopic ureter to improve overall urinary function.

2. Procedure

The procedure for total ureterectomy of an ectopic ureter involves several critical steps to ensure the successful excision of the abnormal ureter. The following procedural steps are typically followed:

  • Step 1: Preoperative Preparation Prior to the surgical procedure, the patient is prepared by placing a Foley catheter to drain the bladder. This step is essential to facilitate access to the ureter during surgery and to minimize complications related to bladder distension.
  • Step 2: Abdominal Incision An incision is made in the abdominal wall over the area where the ectopic ureter is located. This incision allows the surgeon to access the ureter directly, enabling thorough inspection and evaluation of the surrounding structures.
  • Step 3: Ureter Exposure The ureter is carefully exposed and inspected to assess its condition and the extent of the ectopic termination. This step is crucial for determining the best approach for excision and ensuring that all affected tissue is removed.
  • Step 4: Secondary Incision A second incision may be made in the vagina or perineum, depending on the location of the ectopic ureter's termination. This additional incision provides direct access to the site where the ureter ends, allowing for precise excision.
  • Step 5: Ureter Excision The ectopic ureter is then excised completely. Care is taken to ensure that the surrounding tissues are preserved as much as possible while removing the abnormal ureter to prevent complications.

3. Post-Procedure

After the completion of the ureterectomy, the patient will require careful monitoring and post-operative care. This may include managing pain, monitoring for signs of infection, and ensuring proper urinary function. The Foley catheter may remain in place for a period to allow for adequate bladder drainage while the surgical site heals. Follow-up appointments will be necessary to assess recovery and to ensure that there are no complications arising from the procedure. Patients may also need to be educated about potential changes in urinary function and any necessary lifestyle adjustments following the surgery.

Short Descr REMOVAL OF URETER
Medium Descr URETERECTOMY TOT ECTOPIC URETER CMBN APPR
Long Descr Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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).
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).
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)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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