1 in support of: 2 Table of Contents ICD-10 .................................................................................. 5 Male Genital Organs ............................................................ 6 Urinary Tract ........................................................................ 7 Glomerular Diseases ............................................................ 8 Renal Tubulo-Interstitial Diseases ..................................... 13 Renal Failure ...................................................................... 17 Urolithiasis ......................................................................... 18 Other Disorders of the Kidney and Ureter ........................ 19 Other Diseases of the Urinary System ............................... 22 Diseases of the Male Genital Organs ................................. 26 Non-inflammatory Disorders of the Female Genital Tract .................................................... 31 Other Disorders of the Genitourinary Tract ....................... 33 Philhealth Computation ............................................... 34-35 RVU .................................................................................... 37 KIDNEY ............................................................................... 38 Incision ......................................................................... 38 Excision ........................................................................ 39 Renal Transplantation .................................................. 39 Introduction ................................................................. 40 Repair ........................................................................... 40 Endoscopy .................................................................... 41 Other Procedures ......................................................... 42 URETER .............................................................................. 42 Incision ......................................................................... 42 Excision ........................................................................ 42 Repair ........................................................................... 42 Endoscopy .................................................................... 44 BLADDER ............................................................................ 45 Incision ......................................................................... 45 Excision ........................................................................ 46 Repair ........................................................................... 47 Endoscopy / Cystoscopy/ Urethroscopy / Cystourethroscopy ....................................................... 48 3 TRANSURETHRAL SURGERY ............................................... 49 Urethra and Baldder .................................................... 49 Ureter and Pelvis .......................................................... 51 Vesical Neck and Prostate ............................................ 52 URETHRA ........................................................................... 53 Incision ......................................................................... 53 Excision ........................................................................ 54 Repair ........................................................................... 54 Manipulation ............................................................... 56 PENIS .................................................................................. 56 Incision ......................................................................... 56 Destruction .................................................................. 56 Excision ........................................................................ 57 Introduction ................................................................. 57 Repair ........................................................................... 58 TESTIS ................................................................................. 60 Excision ........................................................................ 60 Repair ........................................................................... 60 EPIDIDYMIS ........................................................................ 61 Incision ......................................................................... 61 Excision ........................................................................ 61 Repair ........................................................................... 61 SCROTUM .......................................................................... 62 Incision ......................................................................... 62 Excision ........................................................................ 62 Repair ........................................................................... 62 VAS DEFERENS ................................................................... 63 Incision ......................................................................... 63 Repair ........................................................................... 63 SPERMATIC CORD .............................................................. 63 Excision ........................................................................ 63 SEMINAL VESICLES ............................................................. 63 Incision ......................................................................... 63 Excision ........................................................................ 63 PROSTATE ........................................................................... 64 Incision ......................................................................... 64 Excision ........................................................................ 64 4 ICD-10 5 C60-C63 Male genital organs C00-C75 Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphoid, haematopoietic and related tissue Malignant neoplasms of male genital organs Includes: skin of male genital organs Malignant neoplasm of penis Prepuce Foreskin Glans penis Body of penis Corpus cavernosum Overlapping lesion of penis Penis, unspecified Skin of penis NOS Malignant neoplasm of prostate Malignant neoplasm of testis Undescended testis Ectopic testis [site of neoplasm] Retained testis [site of neoplasm] Descended testis Scrotal testis Testis, unspecified Malignant neoplasm of other and unspecified male genital organs Epididymis Spermatic cord Scrotum Skin of scrotum Other specified male genital organs Seminal vesicle C60-C63 C60 C60.0 C60.1 C60.2 C60.8 C60.9 C61 C62 C62.0 C62.1 C62.9 C63 C63.0 C63.1 C63.2 C63.7 6 C63.8 C63.9 Tunica vaginalis Overlapping lesion of male genital organs Malignant neoplasm of male genital organs whose point of origin cannot be classified to any one of the categories C60-C63.7 Male genital organ, unspecified Male genitourinary tract NOS C64-C68 Urinary tract C00-C75 Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphoid, haematopoietic and related tissue Malignant neoplasms of urinary tract Malignant neoplasm of kidney, except renal pelvis Excludes : renal : calyces : pelvis Malignant neoplasm of renal pelvis Pelviureteric junction Renal calyces Malignant neoplasm of ureter Excludes : ureteric orifice of bladder Malignant neoplasm of bladder Trigone of bladder Dome of bladder Lateral wall of bladder Anterior wall of bladder Posterior wall of bladder Bladder neck Internal urethral orifice Ureteric orifice Urachus C64-C68 C64 C65 C66 C67 C67.0 C67.1 C67.2 C67.3 C67.4 C67.5 C67.6 C67.7 7 C67.8 C67.9 C68 C68.0 C68.1 C68.8 C68.9 Overlapping lesion of bladder Bladder, unspecified Malignant neoplasm of other and unspecified urinary organs Excludes : genitourinary tract NOS: · female · male Urethra Excludes : urethral orifice of bladder Paraurethral gland Overlapping lesion of urinary organs Malignant neoplasm of urinary organs whose point of origin cannot be classified to any one of the categories C64-C68.1 Urinary organ, unspecified Urinary system NOS N00-N99 Glomerular diseases N17-N19 .0 .1 Use additional code, if desired, to identify external cause (Chapter XX) or presence of renal failure Excludes : hypertensive renal disease The following fourth-character subdivisions classify morphological changes and are for use with categories N00-N07. Subdivisions .0-.8 should not normally be used unless these have been specifically identified (e.g. by renal biopsy or autopsy). The three-character categories relate to clinical syndromes. Minor glomerular abnormality Minimal change lesion Focal and segmental glomerular lesions 8 .2 .3 .4 .5 .6 .7 .8 N00 N01 Focal and segmental: · hyalinosis · sclerosis Focal glomerulonephritis Diffuse membranous glomerulonephritis Diffuse mesangial proliferative glomerulonephritis Diffuse endocapillary proliferative glomerulonephritis Diffuse mesangiocapillary glomerulonephritis Membranoproliferative glomerulonephritis, types 1 and 3, or NOS Dense deposit disease Membranoproliferative glomerulonephritis, type 2 Diffuse crescentic glomerulonephritis Extracapillary glomerulonephritis Other Proliferative glomerulonephritis NOS Acute nephritic syndrome Includes : acute: · glomerular disease · glomerulonephritis · nephritis · renal disease NOS Excludes : acute infectious tubulo-interstitial nephritis nephritic syndrome NOS Rapidly progressive nephritic syndrome Includes : rapidly progressive: · glomerular disease · glomerulonephritis · nephritis Excludes : nephritic syndrome NOS 9 N02 N03 N04 N05 N06 Recurrent and persistent haematuria Includes : haematuria: · benign (familial)(of childhood) · with morphological lesion specified in .0-.8 before N00.Excludes : haematuria NOS Chronic nephritic syndrome Includes : chronic: · glomerular disease · glomerulonephritis · nephritis · renal disease NOS Excludes : chronic tubulo-interstitial nephritis diffuse sclerosing glomerulonephritis nephritic syndrome NOS Nephrotic syndrome Includes : congenital nephrotic syndrome lipoid nephrosis Unspecified nephritic syndrome Includes : glomerular disease Glomerulonephritis Nephritis nephropathy NOS and renal disease NOS with morphological lesion specified in .0-.8 before N00.Excludes : nephropathy NOS with no stated morphological lesion renal disease NOS with no stated morphological lesion tubulointerstitial nephritis NOS Isolated proteinuria with specified morphological lesion 10 N07 N08* N08.0* Includes: proteinuria (isolated)(orthostatic)(persistent) with morphological lesion specified in .0-.8 before N00.Excludes : proteinuria: · NOS ( R80 ) · Bence Jones ( R80 ) · gestational ( O12.1 ) · isolated NOS ( R80 ) · orthostatic NOS ( N39.2 ) · persistent NOS ( N39.1 ) Hereditary nephropathy, not elsewhere classified Excludes : Alport’s syndrome (Q87.8) hereditary amyloid nephropathy (E85.0) nail patella syndrome (Q87.2) non-neuropathic heredofamilial amyloidosis (E85.0) Glomerular disorders in diseases classified elsewhere Includes : nephropathy in diseases classified elsewhere Excludes : renal tubulo-interstitial disorders in diseases classified elsewhere Glomerular disorders in infectious and parasitic diseases classified elsewhere Glomerular disorders in: · Plasmodium malariae malaria (B52.0+) · mumps ( B26.8+ ) · schistosomiasis [bilharziasis] (B65.-+) · septicaemia (A40-A41+) 11 N08.1* N08.2* N08.3* N08.4* N08.5* · strongyloidiasis (B78.-+) · syphilis (A52.7+) Glomerular disorders in neoplastic diseases Glomerular disorders in multiple myeloma (C90.0+) · Waldenström’s macroglobulinaemia (C88.0+) Glomerular disorders in blood diseases and disorders involving the immune mechanism Glomerular disorders in: · cryoglobulinaemia (D89.1+) · disseminated intravascular coagulation [defibrination syndrome] (D65+ ) · haemolytic-uraemic syndrome (D59.3+ ) · Henoch(-Schönlein) purpura (D69.0+) · sickle-cell disorders (D57.-+) Glomerular disorders in diabetes mellitus (E10-E14+ with common fourth character .2) Glomerular disorders in other endocrine, nutritional and metabolic diseases Glomerular disorders in: · amyloidosis (E85.-+) · Fabry(-Anderson) disease (E75.2+) · lecithin cholesterol acyltransferase deficiency (E78.6+) Glomerular disorders in systemic connective tissue disorders Glomerular disorders in: · Goodpasture’s syndrome (M31.0+) · microscopic polyangiitis (M31.7+) 12 N08.8* · systemic lupus erythematosus (M32.1+ ) · thrombotic thrombocytopenic purpura (M31.1+) · Wegener’s granulomatosis (M31.3+) Glomerular disorders in other diseases classified elsewhere Glomerular disorders in subacute bacterial endocarditis ( I33.0+ ) N10-N16 Renal tubulo-interstitial diseases Includes : pyelonephritis Excludes : pyeloureteritis cystic N10 Acute tubulo-interstitial nephritis Acute: · infectious interstitial nephritis · pyelitis · pyelonephritis N11 Chronic tubulo-interstitial nephritis Includes : chronic: · infectious interstitial nephritis · pyelitis · pyelonephritis N11.0 Nonobstructive reflux-associated chronic pyelonephritis Pyelonephritis (chronic) associated with (vesicoureteral) reflux Excludes : vesicoureteral reflux NOS ( N13.7 ) N11.1 Chronic obstructive pyelonephritis Pyelonephritis (chronic) associated with: · anomaly } of { pelviureteric junction 13 · kinking } pyeloureteric junction · obstruction } { ureter · stricture Excludes : calculous pyelonephritis (N20.9) obstructive uropathy (N13.-) N11.8 Other chronic tubulo-interstitial nephritis Nonobstructive chronic pyelonephritis NOS N11.9 Chronic tubulo-interstitial nephritis, unspecified Chronic : · interstitial nephritis NOS · pyelitis NOS · pyelonephritis NOS N13 Obstructive and reflux uropathy Excludes: calculus of kidney and ureter without hydronephrosis (N20.-) congenital obstructive defects of renal pelvis and ureter (Q62.0-Q62.3) obstructive pyelonephritis ( N11.1 ) N13.0 Hydronephrosis with ureteropelvic junction obstruction Excludes : with infection ( N13.6 ) N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified Excludes : with infection ( N13.6 ) N13.2 Hydronephrosis with renal and ureteral calculous obstruction Excludes : with infection ( N13.6 ) N13.3 Other and unspecified hydronephrosis Excludes : with infection ( N13.6 ) N13.4 Hydroureter Excludes : with infection ( N13.6 ) N13.5 Kinking and stricture of ureter without hydronephrosis 14 N13.6 N13.7 N13.8 N13.9 N14 N14.0 N14.1 N14.2 N14.3 N14.4 N15 N15.0 N15.1 N15.8 N15.9 N16* Excludes : with infection ( N13.6 ) Pyonephrosis Conditions in N13.0-N13.5 with infection Obstructive uropathy with infection Vesicoureteral-reflux-associated uropathy Vesicoureteral reflux: · NOS · with scarring Excludes : reflux-associated pyelonephritis (N11.0) Other obstructive and reflux uropathy Obstructive and reflux uropathy, unspecified Urinary tract obstruction NOS Drug- and heavy-metal-induced tubulointerstitial and tubular conditions Analgesic nephropathy Nephropathy induced by other drugs, medicaments and biological substances Nephropathy induced by unspecified drug, medicament or biological substance Nephropathy induced by heavy metals Toxic nephropathy, not elsewhere classified Other renal tubulo-interstitial diseases Balkan nephropathy Balkan endemic nephropathy Renal and perinephric abscess Other specified renal tubulo-interstitial diseases Renal tubulo-interstitial disease, unspecified Infection of kidney NOS Excludes : urinary tract infection NOS ( N39.0 ) Renal tubulo-interstitial disorders in diseases classified elsewhere 15 N16.0* N16.1* N16.2* N16.3* N16.4* N16.5* Renal tubulo-interstitial disorders in infectious and parasitic diseases classified elsewhere Renal tubulo-interstitial disorders (due to)(in): · brucellosis · diphtheria · salmonella infection · septicaemia · toxoplasmosis Renal tubulo-interstitial disorders in neoplastic diseases Renal tubulo-interstitial disorders in: · leukaemia · lymphoma · multiple myeloma Renal tubulo-interstitial disorders in blood diseases and disorders involving the immune mechanism Renal tubulo-interstitial disorders in: · mixed cryoglobulinaemia · sarcoidosis Renal tubulo-interstitial disorders in metabolic diseases Renal tubulo-interstitial disorders in: · cystinosis · glycogen storage disease · Wilson’s disease Renal tubulo-interstitial disorders in systemic connective tissue disorders Renal tubulo-interstitial disorders in: · sicca syndrome [Sjögren] · systemic lupus erythematosus Renal tubulo-interstitial disorders in transplant rejection 16 N16.8* Renal tubulo-interstitial disorders in other diseases classified elsewhere N17-N19 Renal failure Excludes: N17 N17.0 N17.1 N17.2 congenital renal failure drug- and heavy-metal-induced tubulointerstitial and tubular conditions extrarenal uraemia haemolytic-uraemic syndrome hepatorenal syndrome · postpartum prerenal uraemia renal failure: · complicating abortion or ectopic or molar pregnancy · following labour and delivery · postprocedural Acute renal failure Includes : acute renal impairment Acute renal failure with tubular necrosis Tubular necrosis: · NOS · acute · renal Acute renal failure with acute cortical necrosis Cortical necrosis: · NOS · acute · renal Acute renal failure with medullary necrosis Medullary [papillary] necrosis: · NOS · acute 17 N17.8 N17.9 N18 N18.0 N18.8 N18.9 N19 · renal Other acute renal failure Acute renal failure, unspecified Chronic renal failure Includes : chronic uraemia diffuse sclerosing glomerulonephritis Excludes : chronic renal failure with hypertension End-stage renal disease Other chronic renal failure Uraemic: · neuropathy+ · pericarditis+ Chronic renal failure, unspecified Unspecified renal failure Uraemia NOS Excludes : renal failure with hypertension uraemia of newborn N20-N23 Urolithiasis N20 N20.0 N20.1 N20.2 N20.9 Calculus of kidney and ureter Excludes : with hydronephrosis Calculus of kidney Nephrolithiasis NOS Renal calculus or stone Staghorn calculus Stone in kidney Calculus of ureter Ureteric stone Calculus of kidney with calculus of ureter Urinary calculus, unspecified 18 N21 N21.0 N21.1 N21.8 N21.9 N22* N22.0* N22.8* N23 Calculous pyelonephritis Calculus of lower urinary tract Includes : with cystitis and urethritis Calculus in bladder Calculus in diverticulum of bladder Urinary bladder stone Excludes : staghorn calculus Calculus in urethra Other lower urinary tract calculus Calculus of lower urinary tract, unspecified Calculus of urinary tract in diseases classified elsewhere Urinary calculus in schistosomiasis [bilharziasis] Calculus of urinary tract in other diseases classified elsewhere Unspecified renal colic N25-N29 Other disorders of the kidney and ureter Excludes: N25 N25.0 N25.1 with Urolithiasis Disorders resulting from impaired renal tubular function Excludes : metabolic disorders classifiable to E70-E90 Renal osteodystrophy Azotaemic osteodystrophy Phosphate-losing tubular disorders Renal: · rickets ·short stature Nephrogenic diabetes insipidus 19 N25.8 N25.9 N26 N27 N27.0 N27.1 N27.9 N28 N28.0 Other disorders resulting from impaired renal tubular function Lightwood-Albright syndrome Renal tubular acidosis NOS Secondary hyperparathyroidism of renal origin Disorder resulting from impaired renal tubular function, unspecified Unspecified contracted kidney Atrophy of kidney (terminal) Renal sclerosis NOS Excludes : contracted kidney with hypertension diffuse sclerosing glomerulonephritis hypertensive nephrosclerosis (arteriolar)(arteriosclerotic) small kidney of unknown cause Small kidney of unknown cause Small kidney, unilateral Small kidney, bilateral Small kidney, unspecified Other disorders of kidney and ureter, not elsewhere classified Excludes : hydroureter renal disease: · acute NOS · chronic NOS ureteric kinking and stricture: · with hydronephrosis · without hydronephrosis Ischaemia and infarction of kidney Renal artery: 20 N28.1 N28.8 N28.9 N29* N29.0* N29.1* · embolism · obstruction · occlusion · thrombosis Renal infarct Excludes : Goldblatt’s kidney renal artery (extrarenal part): · atherosclerosis · congenital stenosis Cyst of kidney, acquired Cyst (multiple)(solitary) of kidney, acquired Excludes : cystic kidney disease (congenital) Other specified disorders of kidney and ureter Hypertrophy of kidney Megaloureter Pyelitis Pyeloureteritis Ureteritis Ureterocele Disorder of kidney and ureter, unspecified Nephropathy NOS Renal disease NOS Excludes : nephropathy NOS and renal disease NOS with morphological lesion specified in .0-.8 before N00. Other disorders of kidney and ureter in diseases classified elsewhere Late syphilis of kidney Other disorders of kidney and ureter in infectious and parasitic diseases classified elsewhere Disorders of kidney and ureter in: 21 · schistosomiasis [bilharziasis · tuberculosis N30-N39 Other diseases of the urinary system N30 N30.0 N30.1 N30.2 N30.3 N30.4 N30.8 N30.9 N31 Excludes : urinary infection (complicating) · abortion or ectopic or molar pregnancy · pregnancy, childbirth and the puerperium · with Urolithiasis Cystitis Excludes: prostatocystitis Acute cystitis Excludes : irradiation cystitis Trigonitis Interstitial cystitis (chronic) Other chronic cystitis Trigonitis Urethrotrigonitis Irradiation cystitis Other cystitis Abscess of bladder Cystitis, unspecified Neuromuscular dysfunction of bladder, not elsewhere classified Excludes : cord bladder NOS due to spinal cord lesion neurogenic bladder due to cauda equina syndrome (G83.4) urinary incontinence: · NOS · specified 22 N31.0 N31.1 N31.2 N31.8 N31.9 N32 N32.0 N32.1 N32.2 N32.3 N32.4 N32.8 Uninhibited neuropathic bladder, not elsewhere classified Reflex neuropathic bladder, not elsewhere classified Flaccid neuropathic bladder, not elsewhere classified Neuropathic bladder: · atonic (motor)(sensory) · autonomous · nonreflex Other neuromuscular dysfunction of bladder Neuromuscular dysfunction of bladder, unspecified Neurogenic bladder dysfunction NOS Other disorders of bladder Excludes : calculus in bladder Cystocele hernia or prolapse of bladder, female Bladder-neck obstruction Bladder-neck stenosis (acquired) Vesicointestinal fistula Vesicorectal fistula Vesical fistula, not elsewhere classified Excludes : fistula between bladder and female genital tract Diverticulum of bladder Diverticulitis of bladder Excludes : calculus in diverticulum of bladder Rupture of bladder, nontraumatic Other specified disorders of bladder Bladder : · calcified · contracted 23 N32.9 N33* N33.0* N33.8* N34 N34.0 N34.1 N34.2 N34.3 N35 Bladder disorder, unspecified Bladder disorders in diseases classified elsewhere Tuberculous cystitis Bladder disorders in other diseases classified elsewhere Bladder disorder in schistosomiasis [bilharziasis] Urethritis and urethral syndrome Excludes : Reiter’s disease urethritis in diseases with a predominantly sexual mode of transmission urethrotrigonitis Urethral abscess Abscess (of): · Cowper’s gland · Littré’s gland · periurethral · urethral (gland) Excludes : urethral caruncle Nonspecific urethritis Urethritis: · nongonococcal · nonvenereal Other urethritis Meatitis, urethral Ulcer of urethra (meatus) Urethritis: · NOS · postmenopausal Urethral syndrome, unspecified Urethral stricture Excludes : postprocedural urethral stricture 24 N35.0 N35.1 N35.8 N35.9 N36 N36.0 N36.1 N36.2 N36.3 N36.8 N36.9 N37* N37.0* N37.8* Post-traumatic urethral stricture Stricture of urethra as a sequela of: · childbirth · injury Postinfective urethral stricture, not elsewhere classified Other urethral stricture Urethral stricture, unspecified Pinhole meatus NOS Other disorders of urethra Urethral fistula False urethral passage Fistula: · urethroperineal · urethrorectal · urinary NOS Excludes : fistula: · urethroscrotal · urethrovaginal Urethral diverticulum Urethral caruncle Prolapsed urethral mucosa Prolapse of urethra Urethrocele, male Excludes : urethrocele, female Other specified disorders of urethra Urethral disorder, unspecified Urethral disorders in diseases classified elsewhere Urethritis in diseases classified elsewhere Candidal urethritis Other urethral disorders in diseases classified elsewhere 25 N39 N39.0 N39.1 N39.2 N39.3 N39.4 N39.8 N39.9 Other disorders of urinary system Excludes : haematuria: · NOS · recurrent and persistent · with specified morphological proteinuria NOS Urinary tract infection, site not specified Use additional code (B95-B97), if desired, to identify infectious agent. Persistent proteinuria, unspecified Excludes: complicating pregnancy, childbirth and the puerperium with specified morphological lesion Orthostatic proteinuria, unspecified Excludes : with specified morphological lesion Stress incontinence Use additional code (N32.8), if desired, to identify overactive bladder or detrusor muscle hyperactivity. Other specified urinary incontinence Overflow } incontinence Reflex } Urge } Excludes : enuresis NOS urinary incontinence (of): · NOS · nonorganic origin Other specified disorders of urinary system Disorder of urinary system, unspecified N40-N51 Diseases of the male genital organs 26 N40 Hyperplasia of prostate Adenofibromatous hypertrophy } of Prostate Adenoma (benign) } Enlargement (benign) } Fibroadenoma } Fibroma } Hypertrophy (benign) } Myoma } Median bar (prostate) Prostatic obstruction NOS Excludes : benign neoplasms, except adenoma, fibroma and myoma of prostate N41 N41.0 N41.1 N41.2 N41.3 N41.8 N41.9 N42 N42.0 N42.1 N42.2 N42.8 N42.9 N43 N43.0 Inflammatory diseases of prostate Acute prostatitis Chronic prostatitis Abscess of prostate Prostatocystitis Other inflammatory diseases of prostate Inflammatory disease of prostate, unspecified Prostatitis NOS Other disorders of prostate Calculus of prostate Prostatic stone Congestion and haemorrhage of prostate Atrophy of prostate Other specified disorders of prostate Disorder of prostate, unspecified Hydrocele and spermatocele Includes: hydrocele of spermatic cord, testis or tunica vaginalis Excludes : congenital hydrocele Encysted hydrocele 27 N43.1 N43.2 N43.3 N43.4 N44 N45 N45.0 N45.9 N46 N47 N48 N48.0 N48.1 N48.2 Infected hydrocele Other hydrocele Hydrocele, unspecified Spermatocele Torsion of testis Torsion of: · Epididymis · spermatic cord · testicle Orchitis and epididymitis Orchitis, epididymitis and epididymo-orchitis with abscess Orchitis, epididymitis and epididymo-orchitis without abscess Epididymitis NOS Orchitis NOS Male infertility Azoospermia NOS Oligospermia NOS Redundant prepuce, phimosis and paraphimosis Adherent prepuce Tight foreskin Other disorders of penis Leukoplakia of penis Balanitis xerotica obliterans Kraurosis of penis Excludes : carcinoma in situ of penis Balanoposthitis Balanitis Other inflammatory disorders of penis Abscess } of corpus cavernosum and penis Boil } 28 N48.3 N48.4 N48.5 N48.6 N48.8 N48.9 N49 N49.0 N49.1 N49.2 N49.8 N49.9 Carbuncle } Cellulitis } Cavernitis (penis) Priapism Painful erection Impotence of organic origin Excludes : psychogenic impotence Ulcer of penis Induratio penis plastic Peyronie’s disease Plastic induration of penis Other specified disorders of penis Atrophy } of corpus cavernosum and penis Hypertrophy } Thrombosis } Disorder of penis, unspecified Inflammatory disorders of male genital organs, not elsewhere classified Excludes : inflammation of penis orchitis and epididymitis Inflammatory disorders of seminal vesicle Vesiculitis NOS Inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens Vasitis Inflammatory disorders of scrotum Inflammatory disorders of other specified male genital organs Inflammation of multiple sites in male genital organs Inflammatory disorder of unspecified male genital organ Abscess } of unspecified male genital organ Boil } 29 N50 N50.0 N50.1 N50.8 N50.9 N51* N51.0* Carbuncle } Cellulitis } Other disorders of male genital organs Excludes : torsion of testis Atrophy of testis Vascular disorders of male genital organs Haematocele } of male genital organs NOS } Haemorrhage } Haemorrhage Other specified disorders of male genital organs Atrophy } of scrotum, seminal vesicle, spermatic cord, testis [except Hypertrophy } atrophy], tunica vaginalis and vas deferens Oedema } Ulcer } Chylocele, tunica vaginalis (nonfilarial) NOS Fistula, urethroscrotal Stricture of: · spermatic cord · tunica vaginalis · vas deferens Disorder of male genital organs, unspecified Disorders of male genital organs in diseases classified elsewhere Disorders of prostate in diseases classified elsewhere Prostatitis: · gonococcal · trichomonal · tuberculous 30 N51.1* N51.2* N51.8* Disorders of testis and epididymis in diseases classified elsewhere Chlamydial: · epididymitis · orchitis Gonococcal: · epididymitis · orchitis Mumps orchitis Tuberculosis of: · Epididymis · testis Balanitis in diseases classified elsewhere Balanitis: · amoebic · candidal Other disorders of male genital organs in diseases classified elsewhere Filarial chylocele, tunica vaginalis Herpesviral [herpes simplex] infection of male genital tract Tuberculosis of seminal vesicle N80-N98 Non-inflammatory disorders of the female genital tract N81 N81.0 Female genital prolapsed Excludes : genital prolapse complicating pregnancy, labour or delivery prolapse and hernia of ovary and fallopian tube prolapse of vaginal vault after hysterectomy Female urethrocele 31 N81.1 N81.2 N81.3 N81.4 N81.5 N81.6 N81.8 N81.9 N82 N82.0 N82.1 Excludes : urethrocele with: · cystocele · prolapse of uterus Cystocele Cystocele with urethrocele Prolapse of (anterior) vaginal (wall) NOS Excludes : cystocele with prolapse of uterus Incomplete uterovaginal prolapsed Prolapse of cervix NOS Uterine prolapse: · first degree · second degree Complete uterovaginal prolapsed Procidentia (uteri) NOS Third degree uterine prolapsed Uterovaginal prolapse, unspecified Prolapse of uterus NOS Vaginal enterocele Excludes : enterocele with prolapse of uterus Rectocele Prolapse of posterior vaginal wall Excludes : rectal prolapsed rectocele with prolapse of uterus Other female genital prolapsed Deficient perineum Old laceration of muscles of pelvic floor Female genital prolapse, unspecified Fistulae involving female genital tract Excludes : vesicointestinal fistulae Vesicovaginal fistula Other female urinary-genital tract fistulae Fistula: · cervicovesical 32 N82.2 N82.3 N82.4 N82.5 N82.8 N82.9 · ureterovaginal · urethrovaginal · uteroureteric · uterovesical Fistula of vagina to small intestine Fistula of vagina to large intestine Rectovaginal fistula Other female intestinal-genital tract fistulae Intestinouterine fistula Female genital tract-skin fistulae Fistula: · uterus to abdominal wall · vaginoperineal Other female genital tract fistulae Female genital tract fistula, unspecified N99 Other disorders of the Genitourinary Tract N99 Postprocedural disorders of genitourinary system, not elsewhere classified Excludes : irradiation cystitis Postoophorectomy · with pathological fracture states associated with artificial menopause Postprocedural renal failure Postprocedural urethral stricture Postcatheterization urethral stricture Postprocedural pelvic peritoneal adhesions Malfunction of external stoma of urinary tract Postprocedural disorder of genitourinary system, unspecified N99.0 N99.1 N99.4 N99.5 N99.9 33 Philhealth Computation 34 35 Tertiary Hospital Diplomate / Fellow Surgeon RVU x PCF 80 = PF4 For RVU 501and above Surgeon RVU x PCF 56 = PF3 Surgeon RVU x PCF 48 = PF2 With Traning 2nd Tier (Group 5 & 6) Diplomate / Fellow 3rd Tier (Group 2, 3 & 4) Surgeon RVU x PCF 40 = PF1 Maximum of P3200 General Practioner 1st Tier (Group 1) Anesthesiologist 56% of surgeon fee (PF1) Anesthesiologist 48% of surgeon fee (PF1) Anesthesiologist 40% of surgeon fee (PF1) Maximum of P1280 36 RVU 37 URINARY SYSTEM KIDNEY Incision 50010 Renal exploration, not necessitating other specific procedures 50020 Drainage of perirenal or renal abscess 50040 Nephrostomy, nephrotomy w/ drainage 50045 Nephrotomy, w/ exploration 50060 Nephrolithotomy; removal of calculus 50065 secondary surgical operation for calculus 50070 complicated by congenital kidne abnormality 50075 removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) 50080 Percutaneous nephrostolithotomy or pyelostolithotomy, w/ or w/o dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm 58081 over 2 cm 50100 Transection or repositioning of aberrant renal vessels 50120 Pyelotomy; w/ exploration 50125 w/ drainage, pyelostomy 50130 w/ removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) 50135 complicated (eg, secondary operation, congenital kidney abnormality) 38 120 100 100 100 150 170 180 x 200 x 180 200 250 x 180 200 200 x 220 x 200 100 100 120 150 x 130 170 x Excision 50200 Renal biopsy; percutaneous, by trocar or needle 50205 by surgical exposure of kidney 50220 Nephrectomy, including partial ureterectomy, any approach including rib resection; 50225 Nephrectomy, complicated because of previous surgery on same kidney 50230 radical, w/ regional lymphadenectomy and/or vena caval thrombectomy 50234 Nephrectomy w/ total ureterectomy and bladder cuff; through same incision 50236 through separate incision 50240 Nephrectomy, partial 50280 Excision or unroofing of cyst(s) of kidney 50290 Excision of perinephric cyst 10 30 150 180 x 150 200 x 180 225 x 200 200 150 100 100 240 300 180 120 120 150 180 x x x x x x Renal Transplantation 50320 50360 50365 50370 50380 Donor nephrectomy, w/ preparation and maintenance of allograft; from living donor Renal allotransplantation, implantation of graft; excluding donor and recipient nephrectomy w/ recipient nephrectomy Removal of transplanted renal allograft Renal autotransplantation, reimplantation of kidney 39 250 400 150 200 Introduction 50390 50391 Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous NEPHROSTOMY, percutaneous ultrasound guided or fluoroscopy guided Repair 50400 Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, w/ or w/o plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple 50405 complicated (congenital kidney bnormality, secondary pyeloplasty, solitary kidney, calycoplasty) 50500 Nephrorrhaphy, suture of kidney wound or injury 50520 Closure of nephrocutaneous or pyelocutaneous fistula 50525 Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach 50526 thoracic approach 50540 Symphysiotomy for horseshoe kidney w/ or w/o pyeloplasty and/or other plastic procedure, unilateral or bilateral (one operation) 40 20 100 x 180 220 x 200 240 x 150 100 150 200 200 Endoscopy 50551 50553 50555 50557 50559 50561 50570 50572 50574 50575 50576 50578 50580 Renal endoscopy through established nephrostomy or pyelostomy, w/ or w/o irrigation, instillation, or ureteropyelography, exclusive of radiologic service; w/ ureteral catheterization, w/ or w/o dilation of ureter w/ biopsy w/ fulguration and/or incision, w/ or w/o biopsy w/ insertion of radioactive substance w/ or w/o biopsy and/or fulguration w/ removal of foreign body or calculus Renal endoscopy through nephrotomy or pyelotomy, w/ or w/o irrigation, instillation, or ureteropyelography, exclusive of radiologic service; w/ ureteral catheterization, w/ or w/o dilation of ureter w/ biopsy w/ endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent) w/ fulguration and/or incision, w/ or w/o biopsy w/ insertion of radioactive substance, w/ or w/o biopsy and/or fulguration w/ removal of foreign body or calculus 41 38 40 45 31 34 50 40 40 40 50 50 50 50 Other Procedures 50590 Lithotripsy, extracorporeal shock wave URETER Incision 50600 Ureterotomy w/ exploration or drainage 50605 Ureterotomy for insertion of indwelling stent, all types 50610 Ureterolithotomy; upper one-third of ureter 50620 middle one-third of ureter 50630 lower one-third of ureter Excision 50650 Ureterectomy, w/ bladder cuff 50660 Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach Repair 50700 Ureteroplasty, plastic operation on ureter (eg, stricture) 50715 Ureterolysis, w/ or w/o repositioning of ureter for retroperitoneal fibrosis 50722 Ureterolysis for ovarian vein syndrome 50725 Ureterolysis for retrocaval ureter, w/ reanastomosis of upper urinary tract or vena cava 50727 Revision of urinary-cutaneous anastomosis (any type urostomy); 42 100 125 x 80 80 110 100 110 130 x 120 x 130 x 120 144 x 120 120 144 x 120 120 144 x 150 140 50728 50740 50750 50760 50770 50780 50782 50783 50785 50800 50810 50815 50820 50825 50830 w/ repair of fascial defect and hernia Ureteropyelostomy, anastomosis of ureter and renal pelvis Ureterocalycostomy, anastomosis of ureter to renal calyx Ureteroureterostomy Transureteroureterostomy, anastomosis of ureter to contralateral ureter Ureteroneocystostomy; anastomosis of single ureter to bladder anastomosis of duplicated ureter to bladder w/ extensive ureteral tailoring w/ vesico-psoas hitch or bladder flap Ureteroenterostomy, direct anastomosis of ureter to intestine Ureterosigmoidostomy, w/ creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including bowel anastomosis Ureterocolon conduit, including bowel anastomosis Ureteroileal conduit (ileal bladder), including bowel anastomosis (Bricker operation) Continent diversion, including bowel anastomosis using any segment of small and/or large bowel (Kock pouch or Camey enterocystoplasty Urinary undiversion (eg, taking down of ureteroileal conduit, 43 140 150 180 120 144 x 180 150 200 250 200 160 250 250 280 300 180 x 50840 50845 50860 50900 50920 50930 50940 ureterosigmoidostomy or ureteroenterostomy w/ ureteroureterostomy or ureteroneocystostomy) Replacement of all or part of ureter by bowel segment, including bowel anastomosis Cutaneous appendico-vesicostomy Ureterostomy, transplantation of ureter to skin Ureterorrhaphy, suture of ureter Closure of ureterocutaneous fistula Closure of ureterovisceral fistula (including visceral repair) Deligation of ureter 250 250 200 120 100 120 150 120 Endoscopy 50951 50953 50955 50957 50959 Ureteral endoscopy through established ureterostomy, w/ or w/o irrigation, instillation, or ureteropyelography, exclusive of radiologic service; w/ ureteral catheterization, w/ or w/o dilation of ureter w/ biopsy w/ fulguration and/or incision, w/ or w/o biopsy w/ insertion of radioactive substance, w/ or w/o biopsy and/or fulguration (not including provision of material) 44 40 40 40 45 50 144 x 50961 50970 50972 50974 50976 50978 50980 w/ removal of foreign body or calculus Ureteral endoscopy through ureterotomy, w/ or w/o irrigation, instillation, or ureteropyelography, exclusive of radiologic service; w/ ureteral catheterization, w/ or w/o dilation of ureter w/ biopsy w/ fulguration and/or incision, w/ or w/o biopsy w/ insertion of radioactive substance, w/ or w/o biopsy and/or fulguration (not including provision of material) w/ removal of foreign body or calculus BLADDER Incision 51010 Aspiration of bladder; by trocar or intracatheter w/ insertion of suprapubic catheter 51020 Cystotomy or cystostomy; w/ fulguration and/or insertion of radioactive material 51030 w/ cryosurgical destruction of intravesical lesion 51040 Cystostomy, cystotomy w/ drainage 51045 Cystotomy, w/ insertion of ureteral catheter or stent 51050 Cystolithotomy, cystotomy w/ removal of calculus, w/o vesical neck resection 51060 Transvesical ureterolithotomy 45 70 40 40 40 45 50 70 20 50 50 50 40 x 60 70 110 85 x 130 x 51065 51080 Cystotomy, w/ stone basket extraction and/or ultrasonic, electrohydraulic and laser fragmentation of ureteral calculus Drainage of perivesical or prevesical space abscess Excision 51500 Excision of urachal cyst or sinus, w/ or w/o umbilical hernia repair 51520 Cystotomy; for simple excision of vesical neck 51525 for excision of bladder diverticulum, single or multiple 51530 for excision of bladder tumor 51535 Cystotomy for excision, incision, or repair of ureterocele 51550 Cystectomy, partial 51555 complicated (eg, postradiation, previous surgery, difficult location) 51565 Cystectomy, partial, w/ reimplantation of ureter(s) into bladder (ureteroneocystostomy) 51570 Cystectomy, complete; 51575 w/ bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51580 Cystectomy, complete, w/ ureterosigmoidostomy or ureterocutaneous transplantations; 51585 w/ bilateral pelvic lymphadenectomy, 46 100 60 120 120 180 180 150 160 250 200 250 300 260 130 x 51590 51595 51596 51597 including external iliac, hypogastric, and obturator nodes Cystectomy, complete, w/ ureteroileal conduit or sigmoid bladder, including bowel anastomosis; w/ bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes Cystectomy, complete, w/ continent diversion, any technique, using any segment of small and/or large bowel to construct neobladder Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, w/ removal of bladder and ureteral transplantations, w/ or w/o hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof Repair 51800 Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, w/ or w/o wedge resection of posterior vesical neck 51820 Cystourethroplasty w/ unilateral or bilateral ureteroneocystostomy 51840 Anterior vesicourethropexy, or urethropexy 47 350 380 410 450 600 120 180 51841 51845 51860 51880 51900 51920 51925 51940 51960 51980 (Marshall-Marchetti-Krantz type) complicated (eg, secondary repair) Abdomino-vaginal vesical neck suspension, w/ or w/o endoscopic control (eg, Stamey, Raz, modified Pereyra) Cystorrhaphy, suture of bladder wound, injury or rupture Closure of cystostomy Closure of vesicovaginal fistula, abdominal approach Closure of vesicouterine fistula; w/ hysterectomy Closure of bladder exstrophy Enterocystoplasty, including bowel anastomosis Cutaneous vesicostomy 120 160 120 80 45 150 150 200 140 160 80 Endoscopy - Cystoscopy, Urethroscopy, Cystourethroscopy 52000 52005 52007 52010 Cystourethroscopy Cystourethroscopy, w/ ureteral catheterization, w/ or w/o irrigation, instillation, or ureteropyelography, exclusive of radiologic service; w/ brush biopsy of ureter and/or renal pelvis Cystourethroscopy, w/ ejaculatory duct catheterization, w/ or w/o irrigation, instillation, or duct radiography, exclusive of radiologic service 48 30 40 x 40 50 x 40 40 TRANSURETHRAL SURGERY Urethra and Bladder 52204 52214 52224 52234 52235 52240 52250 52260 52265 52270 52275 52276 Cystourethroscopy, w/ biopsy Cystourethroscopy, w/ fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands Cystourethroscopy, w/ fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) w/ or w/o biopsy Cystrourethroscopy, w/ fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 cm to 2.0 cm) MEDIUM bladder tumor(s) (2.0 to 5.0 cm) LARGE bladder tumor(s) Cystourethroscopy w/ insertionof radioactive substance, w/ or w/o biopsy or fulguration Cystourethroscopy, w/ dilation of bladder for insterstitial cystitis; general or conduction (spinal) anesthesia local anesthesia Cystourethroscopy, w/ internal urethrotomy; female male Cystourethroscopy w/ direct vision internal urethrotomy 49 55 65 x 60 70 x 60 70 x 100 110 130 120 x 135 x 160 x 160 70 30 60 60 75 75 x x 70 85 x 52277 52281 52283 52285 52290 52300 52301 52305 52310 52317 Cystourethroscopy, w/ resection of external sphincter (sphincterotomy) Cystourethroscopy, w/ calibration and/or dilation of urethral stricture or stenosis, w/ or w/o meatotomy and injection procedure for cystography, male or female Cystourethroscopy, w/ steroid injection into stricture Cystourethroscopy, for treatment of the female urethral syndrome w/ any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone Cystourethroscopy; w/ ureteral meatotomy, unilateral or bilateral w/ resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral w/ resection or fulguration of ectopic ureterocele(s), unilateral or bilateral w/ incision or resection of orifice of bladder diverticulum, single or multiple Cystourethroscopy, w/ removal of foreign body, calculus, or URETERAL STENT from urethra or bladder Litholapaxy: crushing or fragmentation 50 80 30 30 60 70 110 110 80 50 60 x 52318 of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) complicated or large (over 2.5 cm) 90 100 110 x 120 x 60 70 75 50 100 x Ureter and Pelvis 52320 52325 52327 52330 52332 52334 52335 52336 52337 Cystourethroscopy (including ureteral catheterization); w/ removal of ureteral calculus w/ fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic, laser technique) w/ subureteric injection of implant material w/ manipulation, w/o removal of ureteral calculus Cystourethroscopy, w/ insertion of indwelling URETERAL STENT (eg, Gibbons or double-J type) Cystourethroscopy w/ insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde Cystourethroscopy, w/ URETEROSCOPY and/or pyeloscopy (includes dilation of the ureter and/or pyeloureteral junction by any method); w/ removal or manipulation of calculus (ureteral catheterization is included) w/ lithotripsy (ureteral catheterization is included) 51 x 60 50 60 x 50 60 x 70 85 x 80 100 x 52338 52339 w/ biopsy and/or fulguration of lesion w/ resection of tumor 110 110 80 Vesical Neck and Prostate 52340 52450 52500 52510 52601 52606 52612 52614 52620 Cystourethroscopy w/ incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds Transurethral incision of prostate Transurethral resection of bladder neck Transurethral balloon dilation of the prostatic urethra, any method Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) Transurethral fulguration for postoperative bleeding occuring after the usual follow-up time Transurethral resection of prostate; first stage of two-stage resection (partial resection) second stage of two-stage resection (resection completed) Transurethral resection; of residual obstructive tissue after 90 days 52 100 110 120 110 x 150 x 150 x 80 200 100 110 110 250 x 52630 52640 52647 52648 52649 52700 postoperative 100 120 x of regrowth of obstructive tissue longer than one year postoperative 130 250 x of postoperative bladder neck contracture 100 120 x Non-contact laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 180 Contact laser vaporization w/ or w/o transurethral resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 180 Cryosurgery or High intensity focused ultrasound of prostate including transurethral resection of prostate Transurethral drainage of prostatic abscess URETHRA Incision 53000 Urethrotomy or urethrostomy, external ; pendulous urethra 53010 perineal urethra, external 53020 Meatotomy, cutting of meatus; except infant 53 80 20 40 15 100 x 53025 53040 53060 53080 infant 40 Drainage of deep periurethral abscess 25 Drainage of Skene’s gland abscess or cyst 15 Drainage of perineal urinary extravasation 30 Excision 53200 Biopsy of urethra 53210 Urethrectomy, total, including cystostomy; female 53215 male 53220 Excision of fulguration of carcinoma of urethra 53230 Excision of urethral diverticulum; female 53235 male 53240 Marsupialization of urethral diverticulum, male or female 53250 Excision of bulbourethral gland (Cowper’s gland) 53260 Excision or fulguration; urethral polyp(s), distal urethra 53265 urethral caruncle 53270 Skene’s glands 53275 urethral prolapse Repair 53400 Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) 53405 second stage (formation of urethra), including urinary diversion 53410 Urethroplasty, one-stage 54 15 110 130 50 100 90 25 80 15 15 15 25 200 180 53415 53420 53425 53430 53440 53442 53443 53445 53447 53449 53450 reconstruction of male anterior urethra Urethroplasty, transpubic or perineal, one stage, for reconstruction or repair of prostatic or membranous urethra Urethroplasty, two-stage reconstruction or repair of prostatic or membranous urethra; first stage second stage Urethroplasty, reconstruction of female urethra Operation for correction of male urinary incontinence, w/ or w/o introduction of prosthesis Removal of perineal prosthesis introduced for continence Urethroplasty w/ tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) Operation for correction of urinary incontinence w/ placement of inflatable urethral or bladder neck sphincter, including placement of pump and/or reservoir Removal, repair, or replacement of inflatable sphincter including pump and/or reservoir and/or cuff Surgical correction of hydraulic abnormality of inflatable sphincter device Urethromeatoplasty, w/ mucosal 55 90 280 250 180 100 100 100 210 220 280 100 53460 53502 53505 53510 53515 53520 advancement Urethromeatoplasty, w/ partial excision of distal urethral segment (Richardson type procedure) Urethrorrhaphy, suture of urethral wound or injury, female Urethrorrhaphy, suture of urethral wound or injury; penile perineal prostatomembranous Closure of urethrostomy or urethrocutaneous fistula, male 40 40 50 50 60 60 30 Manipulation 53600 53605 53665 Dilation of urethral stricture by passage of sound or urethral dilator, male 15 Dilation of urethral stricture or vesical neck, male, general or conduction (spinal) anesthesia 15 Dilation of female urethra, general or conduction (spinal) anesthesia 15 Male Genital System PENIS Incision 54015 Incision and drainage of penis Destruction 54050 Destruction of lesion(s), penis (eg, 56 10 20 x 20 x 20 x condyloma, papilloma, molluscum contagiosum, herpetic vesicle), any method Excision 54100 Biopsy of penis 54110 Excision of penile plaque (Peyronie disease); 54111 w/ graft to 5 cm in length 54112 w/ graft greater than 5 cm in length 54115 Removal of foreign body from deep penile tissue (eg, plastic implant) 54120 Amputation of penis; partial 54125 complete 54130 Amputation of penis, radical; w/ bilateral inguinofemoral lymphadenectomy 54135 in continuity w/ bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 54150 Circumcision, using clamp or other device; newborn 54152 except newborn 54160 Circumcision, surgical excision other than clamp, device or dorsal slit; newborn 54161 except newborn 10 6 25 60 70 40 60 125 250 300 15 15 15 15 Introduction 54200 54205 54220 Injection procedure for Peyronie disease; 15 w/ surgical exposure of plaque 20 Irrigation of corpora cavernosa 57 for priapism 30 Repair 54300 Plastic operation of penis for straightening of chordee (eg, hypospadias), w/ or w/o mobilization of urethra 54304 Plastic operation on penis for correction of chordee or for first stage hypospadias repair w/ or w/o transplantation of prepuce and/or skin flaps 54308 Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm 54312 greater than 3 cm 54316 Urethroplasty for second stage hypospadias repair (including urinary diversion) w/ free skin graft obtained from site other than genitalia 54318 Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) 54322 One stage distal hypospadias repair (w/ or w/o chordee or circumcision); w/ simple meatal advancement (eg, Magpi, V-flap) 54324 w/ urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) 54326 w/ urethroplasty by local skin flaps and mobilization of urethra 54328 w/ extensive dissection to correct 58 40 50 x 75 90 x 150 150 150 80 180 180 180 54332 54336 54340 54344 54348 54352 54380 54385 chordee and urethroplasty w/ local skin flaps, skin graft patch, and/or island flap One stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap One stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap Repair of hypospadias complications (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple requiring mobilization of skin flaps and urethroplasty w/ flap or patch graft requiring extensive dissection and urethroplasty w/ flap, patch or tubed graft (includes urinary diversion) Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts Plastic operation on penis for epispadias distal to external sphincter; w/ incontinence 59 200 220 220 220 100 120 250 200 220 54390 54420 54430 54435 54440 w/ exstrophy of bladder Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism Plastic operation of penis for injury TESTIS Excision 54500 Biopsy of testis, needle 54505 Biopsy of testis, incisional 54510 Excision of local lesion of testis 54520 Orchiectomy, simple (including subcapsular), w/ or w/o testicular prosthesis, scrotal or inguinal approach 54522 Bilateral Orchiectomy 54530 Orchiectomy, radical, for tumor; inguinal approach 54535 w/ abdominal exploration 54550 Exploration for undescended testis (inguinal or scrotal area) 54560 Exploration for undescended testis w/ abdominal exploration Repair 60 250 80 80 40 80 6 15 20 20 x 50 60 x 120 x 50 70 65 84 x x 50 60 x 70 85 x 54600 Reduction of torsion of testis, surgical, w/ or w/o fixation of contralateral testis emergency 54620 Fixation of contralateral testis 54640 Orchiopexy, inguinal approach, w/ or w/o hernia repair 54650 Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) 54670 Suture or repair of testicular injury 54680 Transplantation of testis(es) to thigh (because of scrotal destruction) 40 EPIDIDYMIS Incision 54700 Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) 12 Excision 54800 Biopsy of epididymis, needle 54820 Exploration of epididymis, w/ or w/o biopsy 54830 Excision of local lesion of epidydimis 54840 Excision of spermatocele, w/ or w/o epididymectomy 54860 Epididymectomy; unilateral 54861 bilateral Repair 54900 Epididymovasostomy, anastomosis 61 50 65 x 50 60 x 70 30 85 50 x x 20 20 25 x 25 25 35 30 x 25 6 54901 55060 of epididymis to vas deferens; unilateral bilateral Repair of Tunica Vaginalis hydrocoele ( Bottle type ) 60 100 40 Incision 55000 Puncture aspiration of hydrocele, tunica vaginalis, w/ or w/o injection of medication 6 Excision 55040 Excision of hydrocele; unilateral 55041 bilateral 40 60 Scrotum Incision 55100 Drainage of scrotal wall abscess 55110 Scrotal exploration 55120 Removal of foreign body in scrotum Drainage and debridement of Fourniers gangrene of the scrotum Repeat debridement for Fournier’s gangrene, per session Excision 55150 Resection of scrotum Repair 55175 Scrotoplasty x 50 x 100 x 6 25 12 15 20 62 50 50 x 25 x VAS DEFERENS Incision 55200 Vasotomy, cannulization w/ or w/o incision of vas, unilateral or bilateral 55250 Vasectomy, unilateral or bilateral 2 15 Repair 55400 Vasovasostomy, vasovasorrhaphy 60 SPERMATIC CORD Excision 55500 Excision of hydrocele of spermatic cord, unilateral 55520 Excision of lesion of spermatic cord 55530 Excision of varicocele or ligation of spermatic veins for varicocele; Excision of varicocoele or ligation of spermatic veins for varicocoele; BILATERAL 55535 abdominal approach 55540 UNILATERAL VARICOCOELECTOMY W/ hernia repair BILATERAL WITH HERNIA REPAIR 40 40 50 x 60 75 x 75 150 x 90 x 75 SEMINAL VESICLES Incision 55600 Vesiculotomy; 55 Excision 55650 Vesiculectomy, any approach 55680 Excision of Mullerian duct cyst 100 100 63 90 x 180 x PROSTATE Incision 55700 Biopsy, prostate; needle or punch, single or multiple, any approach 55720 Prostatotomy, external drainage of prostatic abscess, any approach Excision 55801 Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) 55810 Prostatectomy, perineal radical; 55812 w/ lymph node biopsy(s) (limited pelvic lymphadenectomy) 55815 w/ bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 55821 Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, one or two stages 55831 retropubic, subtotal 55840 Prostatectomy, retropubic radical, w/ or w/o nerve sparing; 55842 w/ lymph node biopsy(s) (limited pelvic lymphadenectomy) 55845 w/ bilateral pelvic lymphadenectomy, 64 20 25 x 20 200 250 240 x 310 x 275 340 x 275 340 x 200 200 240 250 310 x 275 340 x 55860 55862 55865 including external iliac, hypogastric, and obturator nodes Exposure of prostate, any approach, for insertion of radioactive substance; w/ lymph node biopsy(s) (limited pelvic lymphadenectomy) w/ bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes TRANSURETHRAL MICROWAVE THERMOTHERAPY Prostate volume studies for : brachytherapy, cryotherapy, IMRT, EBRT, LINAC 53852 TULIP/TUNA 55873 CRYOSURGICAL THERAPY OF THE PROSTATE 55590 HIFU high intensity focused ultrasound of the prostate including transurethral resection of the prostate 555866 Transperineal placement of pellets for interstitial radiation of the prostate 300 360 x 50 100 150 53850 50541 Laparoscopy, surgical, radical prostatectomy with or without pelvic lymphadenectomy Laparoscopy, surgical, Nephrectomy Laparoscopic surgical ablation of renal cyst 65 250 50 250 400 250 300 x 80 200 x 300 x 200 x 50 60 x 50542 50543 60650 55550 Laparoscopic ablation of renal mass lesion Laparoscopic partial nephrectomy Laparoscopy, surgical, Radical Cystectomy Laparoscopy, surgical, Adrenalectomy, unilateral Laparoscopy, surgical, Varicocoelectomy, unilateral Laparoscopy, surgical, Varicocoelectomy, bilateral Urodynamic studies Voiding Cystourethrogram 66 50 250 50 x 300 200 60 110 x 20 220 x 30 x 30 x 67 68
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