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Official Description

Excision of urethral diverticulum (separate procedure); female

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 53230 refers to the excision of a urethral diverticulum in females, classified as a separate procedure. A urethral diverticulum is a pouch or sac that forms in the urethra, which can lead to various complications, including urinary incontinence, recurrent urinary tract infections, and discomfort. The procedure aims to remove this diverticulum to alleviate symptoms and prevent further complications. The excision can be performed through partial ablation or total excision, depending on the location and extent of the diverticulum. In partial ablation, the diverticular sac is partially removed while preserving some surrounding tissue, whereas total excision involves the complete removal of the diverticulum along with the surrounding mucosal lining. The procedure typically requires careful dissection and suturing to ensure proper healing and function of the urethra post-surgery. Additionally, the use of catheters, such as a Foley catheter or a suprapubic catheter, may be necessary to facilitate drainage and support recovery during the healing process.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The excision of a urethral diverticulum (CPT® Code 53230) is indicated for the following conditions:

  • Urethral Diverticulum The primary indication for this procedure is the presence of a urethral diverticulum in females, which can cause various urinary symptoms.
  • Recurrent Urinary Tract Infections Patients experiencing frequent urinary tract infections that may be associated with the diverticulum may require this procedure for resolution.
  • Urinary Incontinence Women suffering from urinary incontinence linked to the diverticulum may benefit from surgical intervention to alleviate symptoms.
  • Pelvic Pain or Discomfort Chronic pelvic pain or discomfort that is attributed to the diverticulum can also warrant this surgical procedure.

2. Procedure

The procedure for excising a urethral diverticulum involves several detailed steps:

  • Step 1: Preparation The patient is positioned appropriately, and the vagina is prepared and draped to maintain a sterile environment. A Foley catheter is placed transurethrally to facilitate drainage during the procedure.
  • Step 2: Incision A vaginal incision is made, which can be midline vertical, transverse, or U-shaped, with the apex of the incision located distal to the diverticulum. This approach allows for optimal access to the diverticulum.
  • Step 3: Partial Ablation In cases of partial ablation, the periurethral fascia is carefully exposed and dissected into proximal and distal flaps, which helps to reveal the diverticular sac. The body of the diverticular sac is then accessed, and the sac is excised from the surrounding periurethral fascia. A metal probe is inserted through the ostia to identify the opening, and the bulk of the sac is excised while leaving attenuated tissue around the ostia. The probe is subsequently removed, and the remaining attenuated tissue is sutured closed in multiple layers.
  • Step 4: Total Excision For total excision or urethral diverticulectomy, the procedure involves removing the entire diverticular sac along with the surrounding mucosal lining. The vaginal flap is dissected using scissors while preserving the periurethral fascia. The periurethral fascia is opened into proximal and distal flaps, exposing the diverticular sac without entering it. The diverticulum is then dissected circumferentially to the ostia, and the attenuated tissue at the ostia is excised before the entire sac is removed.
  • Step 5: Closure After the diverticulum is excised, the muscular and mucosal layers of the urethral defect are closed vertically over the catheter. The periurethral fascia is then closed transversely, and the anterior vaginal wall is sutured to ensure proper healing. The urethral catheter is left in place to assist with drainage, and if a suprapubic catheter was used, it may be removed or left in place based on the surgeon's discretion.

3. Post-Procedure

Post-procedure care following the excision of a urethral diverticulum includes monitoring for any signs of complications such as infection or excessive bleeding. Patients are typically advised to maintain catheter drainage to facilitate healing and prevent urinary retention. Follow-up appointments are essential to assess the surgical site and ensure proper recovery. Patients may also receive instructions regarding activity restrictions and signs to watch for that may indicate complications. The duration of recovery can vary, but patients are generally encouraged to avoid strenuous activities until cleared by their healthcare provider.

Short Descr REMOVAL OF URETHRA LESION
Medium Descr EXC URETHRAL DIVERTICULUM SPX FEMALE
Long Descr Excision of urethral diverticulum (separate procedure); female
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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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 Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 109 - Procedures on the urethra
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.
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).
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
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