CPT® Code 54130

The procedure described by CPT® Code 54130 involves the radical amputation of the penis, which is performed in conjunction with a bilateral inguinofemoral lymphadenectomy. This surgical intervention is typically indicated for the treatment of malignant tumors or lesions located on the penis. The procedure begins with the isolation of the tumor using a sterile condom or glove, which is placed over the entire penis and secured at the base. An elliptical incision is then made at the base, allowing access to the underlying tissues. The surgeon carefully dissects through the subcutaneous tissue, ligating or fulgurating blood vessels and lymphatic structures as necessary to control bleeding. The penile suspensory ligaments are identified, and the dorsal vein along with the penile arteries are clamped and ligated to ensure complete removal of the affected tissue. The procedure requires meticulous dissection to free the urethra from the corpora cavernosa, followed by division of the urethra at the distal bulbar region, ensuring sufficient length for reconstruction. The corpora cavernosa are then ligated and transected, completing the amputation. In addition to the penile amputation, the procedure includes a bilateral inguinofemoral lymphadenectomy, which involves making an incision parallel to the inguinofemoral ligament. The surgeon elevates skin flaps and dissects deep tissues to identify and excise Cloquet's node, along with any associated nodal tissue. This comprehensive approach is crucial for addressing potential metastasis and ensuring thorough removal of malignant tissues. The procedure concludes with the creation of a perineal urethrostomy, where the urethra is rerouted to the perineum, and appropriate drainage is established to facilitate recovery.