Summary & Overview
CPT 49255: Omentectomy for Metastatic Abdominal or Pelvic Cancer
CPT code 49255 identifies surgical excision of the omentum (omentectomy), commonly performed for metastatic abdominal or pelvic malignancies to reduce tumor burden, assist with staging, or enable cytoreductive therapy. Nationally, this code is relevant because omentectomy is frequently part of complex oncologic surgeries and can affect hospital resource use, operative time, and downstream care pathways.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the common modifier landscape associated with the code. The publication summarizes benchmarks and coverage considerations that influence claims processing and payment variability across major commercial plans and Medicare.
The report provides: an overview of clinical indications and procedure setting; common coding and billing practices tied to oncologic abdominal surgery; and benchmark metrics where available for utilization and reimbursement patterns. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 49255 describes the surgical excision of the omentum, a folded portion of the peritoneum that lines the abdominal cavity, typically performed as part of treatment for metastatic or spreading abdominal or pelvic cancer. This procedure involves removal of the omental tissue to manage tumor burden, reduce peritoneal disease, or assist in staging and cytoreduction.
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Service type: Surgical procedure — open or exploratory abdominal surgery focused on omentectomy for oncologic indication
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Typical site of service: Inpatient hospital operating room or ambulatory surgical center for cases performed with minimally invasive technique; often performed in hospital settings when part of extensive cytoreductive surgery
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old woman with known ovarian carcinoma who presents with evidence of peritoneal carcinomatosis and symptomatic ascites. After staging imaging and multidisciplinary tumor board review, the surgical oncology team schedules a cytoreductive laparotomy. Intraoperatively, visible tumor implants are found on the omentum and the surgeon performs an omentectomy to remove the omentum for tumor debulking and to obtain tissue for pathology. The workflow includes preoperative oncologic evaluation, informed consent noting risks of bleeding and infection, general anesthesia in an operating room or ambulatory surgical center if appropriate, performance of CPT 49255 (excision of omentum), specimen submission to surgical pathology, postoperative recovery with monitoring for ileus or wound complications, and coordination with medical oncology for adjuvant therapy based on final pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple Procedures | When CPT 49255 is one of multiple distinct procedures performed in the same operative session. |
59 |