CPT® Code 50780

An open ureteroneocystostomy is a surgical procedure that involves the anastomosis, or connection, of a single ureter to the bladder. This operation is typically indicated when there is a need to redirect urine flow from the ureter into the bladder, often due to conditions affecting the ureterovesical junction (UVJ). During the procedure, the distal portion of the ureter is carefully divided at or near the UVJ, which is the area where the ureter meets the bladder. An incision is made in the dome of the bladder wall, extending to the level of the mucosa, which is the innermost layer of the bladder. A smaller incision is then created in the bladder mucosa to facilitate the connection with the ureter. The detached segment of the ureter is trimmed to ensure a proper fit and is spatulated, meaning the end is flattened to create a larger surface area for the anastomosis. The full thickness of the ureter is then sutured to the bladder mucosa, ensuring a secure connection. To prevent urine reflux, which can lead to complications, the bladder wall is closed over a 2-3 cm segment of the ureter, creating a tunnel for the ureter. This technique helps maintain the integrity of the connection and supports healing. After the anastomosis is completed, the opening at the UVJ is closed to finalize the procedure. In some cases, a temporary ureteral stent may be placed to ensure that the ureter remains open and to facilitate healing during the recovery process. This procedure is specifically coded as CPT® 50780 when performed on a single ureter, distinguishing it from similar procedures that may involve duplicated ureters or additional surgical techniques.