CPT® Code 54650

An orchiopexy is a surgical procedure aimed at correcting cryptorchidism, a condition where one or both testicles fail to descend into the scrotum. The specific technique described by CPT® Code 54650 involves an abdominal approach for an intra-abdominal testis, commonly referred to as the Fowler-Stephens technique. This procedure can be performed in either a single-stage or a two-stage format. The single-stage approach allows for immediate mobilization of the testis to the scrotum, while the two-stage approach involves an initial surgery to prepare the testis for descent, followed by a second surgery after a period of time to allow for the development of collateral blood supply. The surgery begins with a midline incision in the abdominal wall, through which the surgeon accesses the peritoneal cavity, displaces the intestines, and locates the testis and spermatic cord. The procedure requires careful dissection of the spermatic vessels and manipulation of the gubernaculum, a fibrous structure that aids in the descent of the testis. The ultimate goal of the orchiopexy is to secure the testis in the scrotum, ensuring proper positioning and blood supply, which is crucial for normal testicular function and fertility in the future.