Summary & Overview

CPT 0665T: Open Donor Hysterectomy and Uterus Preservation

CPT code 0665T denotes an open donor hysterectomy in which a living donor’s uterus is surgically removed and preserved on ice in cold preservation solution for transplantation into a recipient. This code captures the unique clinical and logistical steps required for uterus procurement, including operative removal and immediate organ preservation, which are critical to enabling uterus transplant programs and expanding reproductive transplant options.

Key national payers relevant to coverage and coding discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage approaches and payment policies vary across commercial payers and federal programs, reflecting the procedure’s specialized nature and the evolving clinical evidence base.

Readers will find benchmarks and policy-relevant context for billing and reimbursement of donor hysterectomy and uterus preservation, summaries of payer coverage patterns where available, and clinical context explaining the operative and preservation components that the code represents. The publication also outlines common billing modifiers and associated coding considerations. Data not available in the input will be noted where appropriate.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0665TCPTuterus transplantdonor hysterectomyorgan procurementsurgical billingtransplant preservationoperating room services

Billing Code Overview

CPT code 0665T describes an open donor hysterectomy procedure in which the provider removes a uterus from a living donor and preserves the organ on ice in cold preservation solution for subsequent transplantation into a recipient. This service involves donor surgical removal with immediate organ preservation handling.

Service type: Surgical organ procurement (open donor hysterectomy)
Typical site of service: Hospital operating room with immediate organ preservation and transfer to transplant team or organ preservation facility

Clinical & Coding Specifications

Clinical Context

A healthy living donor undergoes an open donor hysterectomy for the purpose of uterus procurement for transplantation. The donor is typically a premenopausal woman who has completed childbearing, has passed donor medical, infectious disease, and psychosocial screening, and consents to organ donation. After general anesthesia and preoperative antibiotics, the surgical team performs an open abdominal approach (midline or Pfannenstiel incision) to mobilize and remove the uterus with preservation of uterine arteries, veins, and supporting structures. The procured uterus is flushed with cold preservation solution, placed on ice, and handed to the organ procurement team for transport to the recipient center. The donor receives postoperative monitoring for hemorrhage, infection, thrombosis, and urinary or pelvic organ complications. The recipient team prepares the transplant recipient concurrently or shortly after procurement for implantation of the donor uterus.

Typical site of service: Hospital operating room with concurrent or coordinated organ procurement logistics.

Service type: Open surgical organ procurement / donor hysterectomy.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typically required for due to complexity or prolonged operative time.

0665T

Taxonomy Code	Specialty	Notes
`163W00000X`	Obstetrics & Gynecology	Gynecologic surgeons commonly perform donor hysterectomy and uterine procurement.
`207L00000X`	General Surgery	General surgeons may participate in abdominal access and complex procurement logistics.
`2080P0004X`	Transplant Surgery	Transplant surgeons coordinate organ procurement and allocation, and may be involved in donor operations.
`363LA2200X`	Reproductive Endocrinology & Infertility	Reproductive specialists coordinate recipient evaluation and postoperative uterine function monitoring.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z52.4`	Organ donor, living	Denotes the donor status for a living uterus donor and justifies procurement-related services.
`Z48.89`	Encounter for other specified postprocedural aftercare	Used for postoperative follow-up related to donor surgery and recovery.
`Z03.89`	Encounter for observation for other suspected diseases and conditions ruled out	May be used for preoperative observation or clearance when needed.
`R53.1`	Weakness	Symptom coding if donor experiences significant postoperative weakness during recovery.
`I82.90`	Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity	Used if donor develops venous thromboembolism as a postoperative complication.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0665T`	Donor hysterectomy with preservation of uterus on ice and in cold preservation solution for transplantation	Primary procedure for uterus procurement from a living donor.
`00790`	Anesthesia for lower abdomen including perineum; for procedures on the uterus	Anesthesia services typically provided for the open donor hysterectomy.
`36415`	Collection of venous blood by venipuncture	Preoperative donor blood draws for crossmatch, infectious disease testing, and labs prior to procurement.
`36416`	Collection of capillary blood specimen	Point-of-care testing for donors when venous access is limited.
`93970`	Duplex scan of abdominal vessels, unilateral or limited	Vascular assessment of pelvic or iliac vessels may be performed preoperatively to evaluate uterine blood supply.
`99223`	Initial hospital inpatient care, typically 70 minutes or more	Complex preoperative or immediate postoperative inpatient evaluation for the donor associated with organ procurement.