CPT 58180 Abdominal Hysterectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58180: Abdominal Hysterectomy, Open Removal of Uterus

CPT code 58180 designates an open abdominal hysterectomy, a surgical removal of the uterus that may include concurrent removal of fallopian tubes and ovaries. This procedure is a core gynecologic operation with significant implications for surgical care patterns, hospital resource use, and payer reimbursement nationally.

Key payers commonly involved in coverage decisions for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for 58180, common sites of service, and typical procedural scope. The publication also summarizes payer coverage considerations and commonly applied modifiers.

The report is designed to help administrators, coding specialists, and policy analysts understand where 58180 fits within surgical service lines, how it is billed across major payers, and what benchmarks and policy issues tend to affect utilization and reimbursement for abdominal hysterectomy. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 58180abdominal hysterectomygynecologysurgical procedureshospital inpatientoutpatient surgeryprocedure codingbilling policyoperating room

Billing Code Overview

CPT code 58180 describes a surgical procedure for removal of the uterus through an abdominal incision. The procedure may include removal of the fallopian tubes and ovaries when performed concurrently.

Service type: Abdominal hysterectomy (open surgical removal of the uterus)
Typical site of service: Hospital inpatient or outpatient surgical setting, performed in an operating room under general or regional anesthesia.

Clinical & Coding Specifications

Clinical Context

A 48-year-old woman with symptomatic uterine fibroids presents with heavy menstrual bleeding, pelvic pressure, and anemia despite medical management. After preoperative evaluation including CBC, basic metabolic panel, and pelvic imaging (transvaginal ultrasound or MRI), the patient is scheduled for an open total abdominal hysterectomy with possible bilateral salpingo-oophorectomy due to concurrent ovarian pathology or patient preference for oophorectomy. The typical clinical workflow includes preoperative clearance and informed consent, preoperative antibiotic prophylaxis, general endotracheal anesthesia, abdominal incision (Pfannenstiel or low midline), ligation of the uterine arteries, removal of the uterus via the abdominal approach, and optional removal of fallopian tubes and ovaries. Postoperative care includes monitoring in PACU, pain control, DVT prophylaxis, wound care instructions, and a planned postoperative visit to assess recovery and pathology results.

Coding Specifications

Modifier selection below focuses on modifiers most relevant to an open total abdominal hysterectomy (58180).

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity of the procedure substantially exceeds typical; document specifics and time.

CPT 58267: Vaginal Hysterectomy with Urethral Suspension

CPT-58210-RADICAL-ABDOMINAL-HYSTERECTOMY-PELVIC-LYMPHADENECTOMY

CPT 58210: Radical Abdominal Hysterectomy with Pelvic Lymphadenectomy

CPT-58260-VAGINAL-HYSTERECTOMY-UTERUS-AND-CERVIX

CPT 58260: Vaginal Hysterectomy, Uterus and Cervix Only

CPT-58280-VAGINAL-HYSTERECTOMY-WITH-ENTEROCELE-REPAIR

CPT 58280: Vaginal Hysterectomy with Enterocele Repair

CPT-58150-ABDOMINAL-HYSTERECTOMY-TOTAL-OR-PARTIAL-OOPHORECTOMY

CPT 58150: Abdominal Hysterectomy with Cervix Removal

CPT-58262-VAGINAL-HYSTERECTOMY-TOTAL-WITH-BSO-NORMAL-SIZE-UTERUS

CPT 58262: Vaginal Hysterectomy with Bilateral Salpingo-Oophorectomy

CPT-58270-VAGINAL-HYSTERECTOMY-SMALL-BOWEL-PROLAPSE-REPAIR

CPT 58270: Vaginal Hysterectomy with Small Bowel Prolapse Repair

CPT-58292-VAGINAL-HYSTERECTOMY-BSO-WITH-BOWEL-REPAIR-UTERUS-GT-250G

CPT 58292: Vaginal Hysterectomy with BSO and Small Bowel Repair

CPT-58200-ABDOMINAL-HYSTERECTOMY-WITH-LYMPHADENECTOMY

CPT 58200: Abdominal Hysterectomy with Lymphadenectomy

CPT-58285-RADICAL-HYSTERECTOMY-FOR-CERVICAL-CANCER

CPT 58285: Radical Hysterectomy for Cervical Cancer

Showing 1–10 of 17

Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology	Primary specialty performing abdominal hysterectomy procedures.
208000000X	General Surgery	May perform hysterectomy in certain settings or for complex pelvic/abdominal pathology.
225100000X	Gynecologic Oncology	Performs radical or complex hysterectomies for malignancy.
363L00000X	Urology	Occasionally involved if urinary tract reconstruction is needed; consultative role.
174400000X	Family Medicine	In limited settings with additional training may perform hysterectomy; uncommon.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N92.0`	Excessive and frequent menstruation with regular cycle	Common indication for hysterectomy when conservative management fails.
`D25.9`	Leiomyoma of uterus, unspecified	Uterine fibroids are a frequent indication for abdominal hysterectomy.
`N80.0`	Endometriosis of uterus (adenomyosis)	Adenomyosis can cause pain and bleeding leading to hysterectomy.
`N91.2`	Amenorrhea, unspecified	Menstrual disorders including amenorrhea may be part of the clinical picture requiring hysterectomy when associated pathology is present.
`C54.9`	Malignant neoplasm of corpus uteri, unspecified	Malignancy is an indication for total abdominal hysterectomy, often with staging and oophorectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58260`	Vaginal hysterectomy, for uterus 250 g or less	Alternative surgical approach; may be used instead of abdominal hysterectomy when feasible.
`58571`	Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)	Minimally invasive alternative commonly performed instead of open abdominal hysterectomy when appropriate.
`58974`	Oophorectomy, for age 12 and older, unilateral or bilateral (via abdominal approach)	May be billed when ovaries are removed separately or in addition to hysterectomy when documentation supports distinct service.
`51725`	Cystourethroscopy, with injection and/or ureteral catheterization, etc.	Performed intraoperatively if urinary tract evaluation is required due to suspected injury or pathology.
`99223`	Initial hospital care, typically 70 minutes or more	Represents typical inpatient admission evaluation by the operating surgeon on the day of major surgery such as `58180`.

OpenPayer