CPT® Code 54861

Epididymectomy is a surgical procedure that involves the removal of the epididymis, which is a coiled tube located at the back of each testis responsible for storing and maturing sperm. This procedure is typically performed under general or regional anesthesia with the patient positioned supine, meaning lying on their back. The surgical area, including the penis and scrotum, is thoroughly 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 divided and ligated at the junction of the convoluted and straight sections. The procedure continues with dissection towards the vaso-epididymal junction, where the epididymis is detached from the testis, and any encountered blood vessels, such as the epididymal artery, are ligated. The removal of the entire specimen is performed with care to ensure that the surgical site is clean and free of bleeding, which is controlled using electrocautery or absorbable sutures. Finally, the testis is returned to the scrotal sac, and the surgical site is closed in layers to promote proper healing. This procedure is indicated for various conditions affecting the epididymis, including infections, cysts, or tumors, and is coded as CPT® 54861 when performed bilaterally.