CPT® Code 50860

The procedure described by CPT® Code 50860 refers to a ureterostomy, specifically the transplantation of the ureter to the skin. This surgical intervention is typically indicated when there is a need to divert urine away from the bladder, often due to conditions affecting the urinary tract. In this procedure, a cutaneous ureterostomy is performed, which involves creating an artificial opening on the abdominal surface to allow urine to exit the body directly from the ureter. The process begins with a lateral incision in the abdomen, where the surgeon carefully divides the overlying muscle and retracts the peritoneum to gain access to the ureter. The ureter is then divided as close to the ureterovesical junction (UVJ) as possible, ensuring that the distal stump is ligated to prevent urine leakage. The proximal ureter is meticulously dissected free from surrounding tissues and brought into the surgical wound. A catheter is introduced through the ureter into the renal pelvis to facilitate kidney drainage, which may be secured to the abdominal wall. Alternatively, a stoma is created, allowing the ureter to be sutured to the abdominal surface, thus diverting urine from the bladder. To complete the procedure, a drain is placed in the abdominal wound, and the incision is closed around this drain to promote healing and prevent fluid accumulation.