CPT® Code 50782

An open ureteroneocystostomy is a surgical procedure that involves the creation of a new connection between a duplicated ureter and the bladder. This procedure is specifically indicated for patients with a duplicated collecting system, which is a congenital condition where a single kidney has two ureters. These ureters may either merge into one or drain separately into the bladder. During the procedure, the distal segment of the ureter is carefully divided at or near the ureterovesical junction (UVJ), which is the point where the ureter meets the bladder. An incision is made in the dome of the bladder wall, extending to the mucosal layer, allowing access for the surgical connection. A smaller incision is then created in the bladder mucosa to facilitate the anastomosis. The detached ureter segment is trimmed and its end is spatulated, which means it is flattened to create a larger surface area for attachment. The full thickness of the ureter is then sutured to the bladder mucosa, ensuring a secure connection. To prevent urinary reflux, the bladder wall is closed over a 2-3 cm segment of the ureter, forming a tunnel that helps maintain the integrity of the connection. The original opening at the UVJ is subsequently closed. In some cases, a temporary ureteral stent may be placed to maintain patency and support the healing process. This procedure is coded as CPT® 50782 when performed on a duplicated ureter, distinguishing it from similar procedures that may involve a single ureter or require additional surgical techniques.