Summary & Overview
CPT 0666T: Laparoscopic/Robotic Donor Hysterectomy with Uterus Preservation
CPT code 0666T represents a laparoscopic or robotic donor hysterectomy with cold preservation of the uterus for transplantation. This emerging surgical service supports uterine transplantation programs by defining a specific billing pathway for minimally invasive donor harvest and organ preservation. Nationally, the code captures a complex, resource-intensive procedure that intersects transplant surgery, obstetrics/gynecology, and specialized perioperative care.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage by commercial insurers and Medicare impacts access to uterine transplantation programs, institutional adoption of minimally invasive donor techniques, and hospital resource planning.
Readers will find an overview of the clinical service and site of care, a summary of typical payer considerations, and context for how the code fits into transplant service lines. The publication also outlines benchmarks and policy-relevant issues affecting billing and reimbursement for donor hysterectomy and organ preservation where available. Data not available in the input will be noted as such in detailed sections.
Billing Code Overview
CPT code 0666T describes a laparoscopic or robotic donor hysterectomy with cold preservation of the uterus for transplantation. The procedure involves harvesting a uterus from a living donor using minimally invasive techniques, followed by preservation of the organ on ice and in cold preservation solution for later implantation into the recipient.
Service type: Surgical organ procurement (donor hysterectomy) for transplantation
Typical site of service: Inpatient hospital or ambulatory surgery center equipped for minimally invasive donor surgery and organ preservation
Clinical & Coding Specifications
Clinical Context
A 32-year-old healthy woman volunteers as a living uterine donor in a paired uterine transplant program. She undergoes preoperative evaluation including pelvic imaging, infectious disease screening, ABO and HLA compatibility testing with the intended recipient, and anesthesia clearance. On the day of surgery, the donor is brought to an operating room equipped for minimally invasive advanced gynecologic surgery and transplantation. Under general anesthesia, the surgical team uses a laparoscopic or robotic approach to mobilize the uterus, preserve the uterine arteries and veins with meticulous dissection, ligate and divide fallopian tubes and supporting ligaments, and remove the uterus. The explanted organ is flushed with cold preservation solution, placed on ice, and transported promptly to the recipient operative team for implantation.
Typical clinical workflow steps:
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Preoperative evaluation: donor medical screening, imaging, and informed consent.
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Operating room setup: laparoscopic/robotic equipment, transplant preservation supplies, and dual teams (donor and recipient) coordinated for timing.
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Donor operation: laparoscopic or robot-assisted hysterectomy with vascular pedicle dissection and organ preservation; hemostasis and closure.
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Organ preservation: immediate perfusion with cold preservation solution, placement on ice, documentation of ischemia times.
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Transfer: transport of preserved uterus to recipient team for implantation; donor postoperative recovery and monitoring for complications such as hemorrhage or thromboembolism.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity is substantially greater than typical for the procedure due to unexpected donor anatomy or extensive adhesiolysis. |
51 | Multiple procedures | Use when the donor undergoes additional distinct surgical procedures during the same anesthetic episode.
52 | Reduced services | Use when the procedure is partially completed or abbreviated but not fully performed.
53 | Discontinued procedure | Use when the procedure is started but stopped for patient safety reasons before completion.
54 | Surgical care only | Use when billing only the surgeon's intraoperative services, with other providers billing pre/postoperative care separately.
55 | Postoperative management only | Use when billing only the postoperative management for the donor and another provider billed the operative portion.
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the donor harvest and both meet reporting criteria.
66 | Surgical team | Use when a surgical team approach is used for portions of the donor procedure.
73 | Discontinued outpatient procedure prior to anesthesia | Use when the outpatient donor procedure is cancelled before anesthesia induction.
78 | Unplanned return to the operating room | Use when the donor requires an unplanned return to the OR for a complication related to the original procedure.
80 | Assistant surgeon | Use when an assistant surgeon participates and meets payer criteria for assistant billing.
81 | Minimum assistant surgeon | Use when a minimal assistant surgeon role is documented and accepted by the payer.
82 | Assistant not available | Use when a qualified assistant surgeon was unavailable and an assistant not fully qualified assisted per payer policy.
AS | Ambulatory surgery center facility | Use to indicate the procedure was performed in an ambulatory surgery center setting when applicable.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2087P0005X | Gynecologic Oncology | Specialists experienced in complex pelvic dissection who may perform donor uterine harvests in tertiary centers. |
207V00000X | Obstetrics & Gynecology | General gynecologic surgeons who perform laparoscopic or robotic uterine harvesting procedures.
207K00000X | Reproductive Endocrinology & Infertility | Providers coordinating transplant candidacy and perioperative care when transplantation is performed for reproductive purposes.
208000000X | Transplant Surgery | Surgeons experienced in organ procurement and preservation; involved in coordinating vascular dissection and preservation protocols.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
Z52.11 | Donor for organ transplant, living donor | Applicable when documenting a living uterine donor status for the surgical encounter. |
Z31.84 | Encounter for assisted reproductive fertility services associated with uterine transplant | Used when transplant is part of fertility treatment planning and coordination.
Z48.812 | Encounter for surgical dressings and sutures removal following organ procurement | Relevant for postoperative donor wound care and follow-up visits.
D68.8 | Other specified coagulation defects | May be present as a comorbidity requiring perioperative management during donor surgery.
I82.90 | Acute embolism and thrombosis of unspecified vein, unspecified site | Represents a possible postoperative complication to monitor for after pelvic surgery and immobilization.
O99.89 | Other maternal diseases classifiable elsewhere, complicating pregnancy, childbirth and the puerperium | Included as a potential relevant comorbidity in reproductive-aged donors when applicable.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0666T | Laparoscopic or robotic harvest of a uterus from a living donor with preservation on ice and in cold preservation solution for transplantation | Primary procedure describing the donor uterus procurement. |
58974 | Laparoscopic hysterectomy, for uterus removal (nonobstetric), total, with or without removal of tubes and/or ovaries; with robotic assisted approach | May be used for donor hysterectomy procedures when performed for non-transplant indications; similar operative technique to donor harvest but not specific to transplantation protocols.
76937 | Ultrasound guidance for vascular access requiring imaging supervision and interpretation | May be used intraoperatively or preoperatively for vascular mapping or central access placement related to donor management.
36415 | Collection of venous blood by venipuncture | Used for preoperative donor laboratory testing, crossmatching, and infectious disease screening prior to donor surgery.
01997 | Unlisted anesthesia procedure, artery, vein, or lymphatics (used when no specific anesthesia code exists for complex transplant donor cases) | May be used to report unusual anesthesia services for complex donor procurement when standard anesthesia codes do not adequately describe services.
36440 | Venous catheterization, for hemodialysis or other long-term access (tunneled central venous catheter) | May be performed preoperatively if long-term vascular access is required for immunomodulation or perioperative management in complex transplant protocols.