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Official Description

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 53454 refers to the procedure involving a periurethral transperineal adjustable balloon continence device, specifically focusing on the percutaneous adjustment of the balloon's fluid volume. This device is primarily utilized in the treatment of urinary incontinence in men, particularly those who have experienced incontinence following prostate surgery or radiation therapy. The procedure aims to restore normal pelvic pressure and urinary continence by employing a balloon mechanism that can be adjusted as needed. The process begins with the insertion of a cystoscope through the urethra into the bladder, allowing for precise placement of the device. A small incision is made in the perineum, and under fluoroscopic guidance, a trocar and sheath are inserted to facilitate the placement of the balloon device. The balloon is inflated with fluid to secure it in position, and adjustments can be made post-operatively to ensure optimal function. This procedure is significant for enhancing the quality of life for patients suffering from urinary incontinence, providing a minimally invasive solution that can be tailored to individual needs.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The periurethral transperineal adjustable balloon continence device procedure is indicated for the following conditions:

  • Urinary Incontinence This procedure is performed to treat men who experience urinary incontinence, particularly after undergoing prostate surgery or radiation therapy.

2. Procedure

The procedure for the placement and adjustment of the periurethral transperineal adjustable balloon continence device involves several key steps:

  • Step 1: Cystoscope Insertion A cystoscope is introduced through the urethra into the bladder, allowing for visualization and access to the urinary tract.
  • Step 2: Incision and Trocar Insertion A small incision is made in the perineum. A sharp-tipped trocar and sheath are assembled and inserted through this incision, which is advanced through the pelvic floor under fluoroscopic guidance.
  • Step 3: Trocar Replacement Once the trocar reaches the level of the bladder, it is replaced with a blunt-tipped trocar to facilitate safe advancement without damaging surrounding tissues.
  • Step 4: Balloon Device Placement The trocar is removed, and the deflated balloon device is advanced through the sheath to the predetermined location. The sheath is then partially retracted, and the balloon is inflated with a small volume of fluid to secure it in place.
  • Step 5: Closure After the balloon is anchored, the sheath is removed, and the incision in the perineum is closed to complete the procedure.
  • Step 6: Post-Operative Adjustment Following a recovery period of a few weeks, the device can be accessed through a needle inserted into the perineum. Additional fluid can be added to the balloon to adjust its volume for optimal pressure, which may be done multiple times as needed.
  • Step 7: Device Removal If removal of the device is necessary, a small incision is made in the perineum, the balloon is deflated, and the device is carefully dissected free from surrounding tissue before being removed.

3. Post-Procedure

After the procedure, patients typically undergo a recovery period during which they may experience some discomfort at the incision site. It is important to monitor the adjustment of the balloon volume to ensure adequate pressure for urinary continence. Follow-up appointments may be necessary to assess the effectiveness of the device and make any required adjustments. If the device needs to be removed, the procedure is straightforward and involves a small incision in the perineum, ensuring minimal disruption to the surrounding tissues.

Short Descr TPRNL BALO CNTNC DEV ADJMT
Medium Descr PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV ADJMT
Long Descr Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume
Status Code Carriers Price the Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No 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 Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE 1
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
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.
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
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
2022-01-01 Added Code added
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Description
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