50815 Urinary diversion Medicare reimbursement rates in Missouri

A ureterosigmoidostomy routes urine from the ureters into the sigmoid colon, where it leaves the body with bowel contents. A urologist typically performs this major reconstructive operation in a hospital operating room, often when the bladder has been removed or cannot serve as a functional reservoir. The procedure involves joining the ureters to the sigmoid bowel; it does not create a separate cutaneous urinary stoma or an isolated continent reservoir.

Select this code when the operative report documents urinary drainage through the sigmoid colon. Distinguish it from diversion with a constructed conduit or continent reservoir, and from other ureter-to-bowel connections based on the actual reconstruction performed. Documentation should identify the bowel segment, ureteral connections, and intended route of urine drainage. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral reporting with modifier 50, payment is at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.