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CPT®
50920

CPT® Code 50920

Official Description

Closure of ureterocutaneous fistula

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 50920 refers to the surgical procedure known as the closure of a ureterocutaneous fistula. A ureterocutaneous fistula is defined as an abnormal connection between the ureter, which is a tube that carries urine from the kidney to the bladder, and the skin. This condition can lead to urine leakage onto the skin, which may cause significant discomfort and increase the risk of infection. The procedure involves identifying the fistula tract, which is the abnormal pathway connecting the ureter to the skin, and excising it to eliminate the abnormal communication. During the surgery, the exposed ureter is carefully examined, and any necessary debridement of the fistulous opening is performed to ensure that the tissue is healthy before closure. The closure process involves suturing the ureter and the surrounding skin and subcutaneous tissues to restore normal anatomy and function. This procedure is critical for patients suffering from this type of fistula, as it aims to prevent further complications and improve the quality of life.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closure of a ureterocutaneous fistula, represented by CPT® Code 50920, is indicated in the following situations:

  • Ureterocutaneous Fistula This procedure is performed when there is an abnormal communication between the ureter and the skin, leading to urine leakage and potential complications such as skin irritation or infection.
  • Post-Surgical Complications It may also be indicated following surgical interventions that inadvertently create a fistula, necessitating closure to restore normal urinary function.
  • Trauma In cases where trauma has resulted in the formation of a ureterocutaneous fistula, surgical closure is required to prevent further complications.

2. Procedure

The procedure for the closure of a ureterocutaneous fistula involves several critical steps:

  • Identification of the Fistula The surgeon begins by exposing the ureter and locating the abnormal communication between the ureter and the skin. This step is crucial for understanding the extent of the fistula and planning the surgical approach.
  • Following the Fistula Tract Once the fistula is identified, the surgeon carefully follows the tract from the ureter to the skin. This involves meticulous dissection to ensure that all affected tissue is addressed.
  • Excision of the Fistula The fistula tract is then excised, which involves removing the abnormal tissue to eliminate the connection between the ureter and the skin. This step is essential to prevent recurrence of the fistula.
  • Debridement of the Ureter The opening in the ureter is debrided as necessary to remove any unhealthy tissue, ensuring that the remaining ureter is viable for closure.
  • Suturing the Ureter After debridement, the ureter is closed with sutures, restoring its integrity and function.
  • Debridement and Closure of Skin and Subcutaneous Tissues In addition to the ureter, the skin and subcutaneous tissues are also debrided and subsequently closed with sutures. This layered closure is important for proper healing and minimizing scarring.
  • Layered Closure of the Operative Wound Finally, the operative wound is closed in layers to ensure that all tissue layers are properly aligned and secured, promoting optimal healing.

3. Post-Procedure

After the closure of a ureterocutaneous fistula, patients typically require monitoring for any signs of complications, such as infection or recurrence of the fistula. Post-operative care may include pain management, wound care instructions, and follow-up appointments to assess healing. Patients are advised to avoid strenuous activities during the initial recovery period to facilitate proper healing. The expected recovery time may vary depending on the individual’s overall health and the complexity of the procedure, but close follow-up is essential to ensure successful outcomes.
Short Descr CLOSURE URETER/SKIN FISTULA
Medium Descr CLOSURE URETEROCUTANEOUS FISTULA
Long Descr Closure of ureterocutaneous fistula
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard 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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 2
CCS Clinical Classification 112 - Other OR therapeutic procedures of urinary tract
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
Date
Action
Notes
Pre-1990 Added Code added.
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Description
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Description
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