CPT 58140 Abdominal Myomectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58140: Abdominal Myomectomy for 1–4 Uterine Fibroids

CPT code 58140 denotes an abdominal myomectomy for excision of one to four uterine fibroid tumors weighing 250 grams or less. This operative code captures a common gynecologic procedure performed to remove symptomatic fibroids while preserving the uterus. It is clinically important given the prevalence of fibroid-related symptoms — including heavy menstrual bleeding, pelvic pain, and bulk symptoms — and the role of myomectomy as a uterus-sparing alternative to hysterectomy.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 58140, typical sites of service, and which payers commonly cover the procedure. The publication includes benchmarking information where available, notes on claim processing considerations and common modifiers, and links to related surgical codes and policy documents.

This summary serves clinicians, billing professionals, and policy analysts seeking a national-level reference on procedural definition, coverage stakeholders, and the practical billing context for abdominal myomectomy under CPT code 58140. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 58140abdominal myomectomygynecologic surgeryuterine fibroidsoperative codesurgical billinghospital operating roomambulatory surgical centerwomen's health

Billing Code Overview

CPT code 58140 describes a surgical procedure in which the physician excises one to four uterine fibroid tumors weighing 250 grams or less via an abdominal approach. This procedure is a focused myomectomy performed through an open abdominal incision rather than laparoscopic or hysteroscopic techniques.

Service type: Surgical removal of uterine fibroids (abdominal myomectomy)
Typical site of service: Hospital operating room or ambulatory surgical center with an abdominal surgical suite

Clinical & Coding Specifications

Clinical Context

A 38-year-old woman presents with symptomatic uterine fibroids causing heavy menstrual bleeding, pelvic pain, and pressure symptoms. Imaging (transvaginal ultrasound or pelvic MRI) confirms 1 to 4 intramural/subserosal fibroid tumors with a combined operative specimen weight estimated to be 250 g or less. Conservative measures (medical therapy with hormonal agents or tranexamic acid) have failed or are contraindicated. The gynecologic surgeon schedules an open abdominal myomectomy via a small low transverse or vertical laparotomy to excise the fibroid(s).

Preoperative workflow includes history and physical, informed consent for myomectomy and possible conversion to hysterectomy, preoperative labs (CBC, type and screen), anesthesia assessment, and perioperative antibiotic prophylaxis. Intraoperative steps include abdominal entry, uterine incision, enucleation of fibroid(s), hemostasis, uterine reconstruction, and abdominal closure. Postoperative workflow includes recovery in PACU, pain control, monitoring for bleeding or infection, and discharge instructions with follow-up for wound check and fertility counseling if applicable.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when operative complexity or time substantially exceeds typical, documented justification for additional work.

CPT 58120: Dilation and Curettage of Uterine Lining

CPT-58110-ENDOMETRIAL-BIOPSY-WITH-COLPOSCOPY

CPT 58110: Endometrial Biopsy Performed with Colposcopy

CPT-58146-ABDOMINAL-MYOMECTOMY-5-PLUS-FIBROIDS-GT-250G

CPT 58146: Abdominal Myomectomy for 5+ Uterine Fibroids, >250 g

CPT-58145-VAGINAL-MYOMECTOMY-UTERINE-FIBROID-EXCISION-1-TO-4-TUMORS

CPT 58145: Vaginal Myomectomy for Excision of 1–4 Uterine Fibroids

CPT-58100-ENDOMETRIAL-BIOPSY-OFFICE-AMBULATORY

CPT 58100: Endometrial Biopsy Without Cervical Dilation

Taxonomy Code	Specialty	Notes
`207V00000X`	Obstetrics & Gynecology	Gynecologic surgeons who commonly perform abdominal myomectomy.
`2080P0005X`	General Surgery	General surgeons trained in pelvic surgery may perform abdominal approaches in select settings.
`363A00000X`	Reproductive Endocrinology / Infertility	Specialists performing fertility-preserving myomectomies in patients seeking future pregnancy.
`193200000X`	Gynecologic Oncology	Gynecologic oncologists may perform complex myomectomies when malignancy is a concern.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D25.0`	Intramural leiomyoma of uterus	Common indication for myomectomy when fibroid is within the uterine wall causing symptoms.
`D25.1`	Subserosal leiomyoma of uterus	Subserosal fibroids causing bulk symptoms or pain; often amenable to abdominal myomectomy.
`D25.2`	Submucous leiomyoma of uterus	Submucosal fibroids may cause heavy bleeding; sometimes removed hysteroscopically, but may require abdominal approach if not amenable.
`N93.8`	Other specified abnormal uterine and vaginal bleeding	Symptom-based diagnosis when fibroids are the suspected cause of abnormal bleeding.
`N80.0`	Endometriosis of uterus (adenomyosis)	Differential or coexisting pathology that may influence surgical planning and symptomatology.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58150`	Myomectomy, submucous, with hysteroscopic approach	Alternative minimally invasive approach for submucosal fibroids; used when fibroids are amenable to hysteroscopic removal.
`58558`	Hysteroscopy, operative, with sampling or removal of lesion(s)	Diagnostic or operative hysteroscopy may be performed preoperatively or concurrently for intrauterine assessment.
`49505`	Repair initial incisional or ventral hernia; reducible	Possible concurrent repair if an abdominal wall hernia is encountered or addressed during the same operation.
`99024`	Postoperative follow-up visit, global service	Used to report routine postoperative follow-up included in the global surgical package where separate reporting is allowed; verify payer rules.
`51702`	Complex cystoscopy; with irrigation and/or distention and/or visualization	Cystoscopy may be performed intraoperatively if bladder or ureteral involvement is suspected or to evaluate urinary tract injury.

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