CPT® Code 51550

Partial cystectomy, as defined by CPT® Code 51550, is a surgical procedure that involves the removal of a portion of the bladder. This procedure is primarily indicated for patients with localized malignant neoplasms of the bladder, which are tumors that are confined to a specific area and have not spread extensively. The surgical approach typically begins with the exposure of the bladder through a low midline or transverse suprapubic incision, allowing the surgeon access to the bladder for the necessary intervention. Depending on the location of the tumor, the surgical approach may vary; lesions located in the posterior bladder are generally accessed via an intraperitoneal approach, while those situated in the dome or anterior bladder are approached extraperitoneally. During the procedure, if indicated, a pelvic lymph node dissection may be performed to assess the spread of cancer. The bladder is carefully mobilized, and stay sutures are placed at a distance from the lesion to facilitate a clear view of the area being treated. The bladder is then incised between these stay sutures, allowing for adequate visualization of the lesion. The excision involves removing the affected portion of the bladder along with surrounding perivesical fat and peritoneum, ensuring that a margin of healthy tissue is included to minimize the risk of cancer recurrence. After the lesion is excised, the bladder wall is reconstructed by closing the submucosa and muscle in layers, ensuring proper healing and function of the bladder post-surgery. This procedure is classified as a simple partial cystectomy, distinguishing it from more complicated cases that may involve prior surgeries, radiation effects, or difficult-to-access lesions.