CPT® Code 54860

Epididymectomy is a surgical procedure that involves the removal of the epididymis, which is a coiled tube located at the back of the testis responsible for storing and maturing sperm. This procedure is typically performed on one side of the scrotum, hence the term "unilateral." The patient is positioned supine, meaning they lie flat on their back, and the surgical area, including the penis and scrotum, is prepared and draped to maintain a sterile environment. A transverse incision is made in the skin of the hemiscrotum, allowing access to the underlying structures. The surgeon employs both sharp and blunt dissection techniques to carefully separate the testis, epididymis, and vas deferens from surrounding tissues, ensuring that these structures are freed and brought into the operative field for further manipulation. If the patient has previously undergone a vasectomy, the dissection will continue above the vasectomy site to ensure complete removal of the epididymis. In cases where no prior vasectomy has been performed, the vas deferens may be cut and ligated with absorbable sutures. The procedure continues with dissection towards the vaso-epididymal junction, where the epididymis is detached from the testis. The surgeon ligates the epididymal artery if encountered and removes the entire specimen intact. After the removal, the surgical site is irrigated, and any bleeding is controlled before closing the incision in layers. This procedure is coded as CPT® Code 54860 for unilateral epididymectomy, while CPT® Code 54861 is used for bilateral procedures.