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The procedure described by CPT® Code 55500 refers to the excision of a hydrocele of the spermatic cord, which is a surgical intervention performed unilaterally and classified as a separate procedure. A hydrocele is a fluid-filled sac surrounding a testicle, often resulting in swelling in the scrotum. The excision is typically conducted through an inguinal incision, which is a common approach for accessing the spermatic cord. During the procedure, the surgeon makes a transverse incision in the skin, which is then extended through the subcutaneous tissue to reach the external oblique aponeurosis. This allows for the opening of the inguinal canal, where the ilioinguinal nerve is identified and isolated to prevent nerve damage during the surgery. The surgical exploration continues until the spermatic cord is located, followed by careful dissection to separate it from the surrounding muscle fibers. The hydrocele sac is then meticulously elevated and dissected away from the spermatic cord structures, ensuring that the spermatic vessels and vas deferens are preserved. The procedure concludes with the transection of the sac, ligation, and closure of the surgical site, which includes the spermatic fascia, external oblique muscle, and skin. This detailed approach is essential for effective treatment while minimizing complications and ensuring proper recovery.
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The excision of a hydrocele of the spermatic cord, as described by CPT® Code 55500, is indicated for the following conditions:
The procedure for excising a hydrocele of the spermatic cord involves several critical steps to ensure successful removal while preserving surrounding structures.
After the excision of the hydrocele, patients can expect specific post-procedure care and recovery considerations. It is essential to monitor the surgical site for any signs of infection or complications. Patients may experience some swelling and discomfort in the area, which can be managed with prescribed pain relief medications. Activity restrictions are typically advised to allow for proper healing, and patients should follow up with their healthcare provider to ensure that the recovery is progressing as expected. Additionally, any sutures used during the procedure may need to be removed at a follow-up appointment, depending on the type of closure performed. Overall, adherence to post-operative instructions is crucial for a successful recovery and to minimize the risk of recurrence or complications.
| Short Descr | REMOVAL OF HYDROCELE | Medium Descr | EXC HYDROCELE SPRMATIC CORD UNI SPX | Long Descr | Excision of hydrocele of spermatic cord, unilateral (separate procedure) | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 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. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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