Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A complete laser enucleation of the prostate is a surgical procedure that utilizes laser technology to remove prostate tissue. This procedure is characterized by the morcellation process, which involves dividing the prostate into smaller fragments to facilitate easier removal. The procedure also includes the management of postoperative bleeding, ensuring that any bleeding that may occur during or after the surgery is effectively controlled. In addition to the primary enucleation, several other procedures may be performed concurrently, such as vasectomy, meatotomy, cystourethroscopy (also known as cystoscopy), urethral calibration and/or dilation, internal urethrotomy, and transurethral resection of the prostate, if deemed necessary. Before the laser enucleation begins, a cystoscopy is conducted to inspect the bladder for any tumors or abnormal masses. Following this, the urethra is calibrated and dilated using a series of instruments known as sounds, which help to prepare the urethra for the procedure. If the meatus, or the opening of the urethra, is found to be narrowed, a meatotomy may be performed to incise and widen it. The procedure employs a continuous flow resectoscope sheath, which is equipped with a laser fiber and a video system to visualize the surgical area. Normal saline is used as an irrigant to maintain a clear view during the procedure. The enucleation process involves sequentially addressing each lobe of the prostate, typically starting with the median lobe. The laser is used to create grooves and separate the lobes from surrounding tissues, ensuring that all attachments are carefully divided. Once the lobes are enucleated, they are pushed into the bladder, where a morcellator is used to cut the tissue into smaller pieces for removal. This comprehensive approach not only addresses the enlargement of the prostate but also minimizes complications and promotes effective recovery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of laser enucleation of the prostate with morcellation is indicated for patients experiencing symptoms related to benign prostatic hyperplasia (BPH) or other conditions that result in prostate enlargement. The following conditions may warrant this surgical intervention:

  • Benign Prostatic Hyperplasia (BPH) - A common condition in older men characterized by an enlarged prostate that can lead to urinary obstruction and other complications.
  • Urinary Retention - Difficulty in urinating or inability to completely empty the bladder due to prostate enlargement.
  • Recurrent Urinary Tract Infections - Frequent infections that may be associated with urinary obstruction caused by an enlarged prostate.
  • Bladder Stones - Formation of stones in the bladder that can occur due to urinary retention and obstruction.
  • Hematuria - Presence of blood in the urine, which may be related to prostate issues.

2. Procedure

The laser enucleation of the prostate with morcellation involves several detailed procedural steps, which are as follows:

  • Cystoscopy - The procedure begins with a cystoscopy to examine the bladder for any tumors or abnormal masses. This step is crucial for assessing the overall condition of the urinary tract.
  • Urethral Calibration and Dilation - Following cystoscopy, the urethra is calibrated and dilated using a series of sounds. This preparation is essential to ensure that the instruments can be properly inserted and maneuvered during the procedure.
  • Meatotomy (if necessary) - If the meatus is found to be narrowed, a meatotomy is performed to incise and widen the opening of the urethra, facilitating better access for the surgical instruments.
  • Placement of Resection Sheath - A continuous flow resectoscope sheath is then placed, followed by the insertion of a laser fiber stabilizing catheter, a video system, and the laser fiber itself. This setup allows for effective visualization and operation during the procedure.
  • Irrigation - Normal saline irrigant is run through the resection tubing into the resectoscope to maintain a clear view of the surgical field.
  • Enucleation of Prostate Lobes - The surgeon uses the resectoscope to visualize the anatomy and determine the extent of enlargement in each lobe of the prostate. The enucleation process typically begins with the median lobe, where a groove is cut with the laser along the sulcus just lateral to the verumontanum. This groove is deepened and widened to separate the median lobe from the lateral lobes.
  • Dissection of Lateral Lobes - After the median lobe is enucleated, the right lateral lobe is dissected free from the capsular floor using a side-to-side motion with the laser. An anterior groove is created to separate the right lateral lobe from the roof of the capsule, and any remaining attachments are cut with the laser.
  • Completion of Enucleation - The left lateral lobe is then enucleated in a similar manner to the right. Once all three lobes have been enucleated and pushed into the bladder, the surgeon controls any bleeding using laser coagulation.
  • Morcellation - The inner sheath of the resectoscope, the laser fiber, and the stabilizing catheter are removed. A morcellator is introduced, and inflow tubing with normal saline is used to distend the bladder. Prostate tissue is isolated, and the morcellator blades are activated to cut the tissue into smaller pieces, which are then removed by suction until the bladder is cleared of all prostate tissue.

3. Post-Procedure

After the laser enucleation of the prostate with morcellation, patients may require monitoring for any postoperative complications, including bleeding or infection. It is essential to ensure that the urinary tract is functioning properly and that there are no signs of obstruction. Patients may experience some discomfort or urinary symptoms as they recover, and follow-up appointments will be necessary to assess healing and the effectiveness of the procedure. Proper hydration and adherence to postoperative care instructions are crucial for a smooth recovery process.

Short Descr PROSTATE LASER ENUCLEATION
Medium Descr LASER ENUCLEATION PROSTATE W/MORCELLATION
Long Descr Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)
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) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 118 - Other OR therapeutic procedures, male genital
GC This service has been performed in part by a resident under the direction of a teaching physician
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.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
SG Ambulatory surgical center (asc) facility service
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).
CR Catastrophe/disaster related
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
RT Right side (used to identify procedures performed on the right side of the body)
TV Special payment rates, holidays/weekends
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2008-01-01 Added First appearance in code book in 2008.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"