CPT 58200 Abdominal Hysterectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58200: Abdominal Hysterectomy with Lymphadenectomy

CPT code 58200 represents an abdominal hysterectomy with removal of the uterus and cervix, often accompanied by unilateral or bilateral salpingo-oophorectomy and resection of the upper vaginal canal plus pelvic and para-aortic lymphadenectomy. This is a high-acuity, operative gynecologic procedure commonly performed for malignancy, extensive benign disease, or staging purposes. Nationally, the code is significant because it denotes inpatient surgical care with substantial resource use, influencing hospital reimbursement, surgical quality measurement, and utilization monitoring.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing context for the code, typical sites of service, and the types of documentation and procedural components embodied in the code descriptor. The publication provides benchmarks and mapping for related service lines, highlights common modifier usage (listed separately), and summarizes implications for coding accuracy and claim adjudication. The content is intended to help coding professionals, revenue integrity teams, and payer policy analysts understand the clinical scope and billing significance of CPT code 58200 at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare58200CPThysterectomygynecologic-surgeryabdominal-surgerylymphadenectomyinpatient-surgerysurgical-coding

Billing Code Overview

CPT code 58200 describes a surgical procedure in which the provider performs an abdominal hysterectomy with removal of the uterus and cervix, and may include removal of the fallopian tubes and ovaries. The procedure also includes resection of the upper one-third of the vaginal canal and removal of specified pelvic and para-aortic lymph nodes as part of the same operative session.

Service type: Major abdominal gynecologic surgery with lymphadenectomy
Typical site of service: Inpatient hospital surgical setting

Clinical & Coding Specifications

Clinical Context

A 58-year-old female presents with early-stage endometrial carcinoma confirmed by endometrial biopsy and preoperative imaging. After multidisciplinary review, the gynecologic oncology team schedules an open total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymph node sampling for staging and treatment. The patient arrives to the hospital on the morning of surgery, obtains informed consent, and undergoes general anesthesia. Intraoperative steps include midline abdominal incision, exploration of the abdomen and pelvis, mobilization and ligation of the uterine vessels, removal of the uterus and cervix with bilateral salpingo-oophorectomy as indicated, resection of the upper one-third of the vaginal cuff as indicated for margin control, and selective pelvic and para-aortic lymph node sampling or dissection. Hemostasis is achieved, drains may be placed per surgeon preference, and the abdomen is closed in layers. Postoperative care includes monitoring in the PACU, routine pain control, DVT prophylaxis, early ambulation, pathology specimen processing for final staging, and coordination with oncology for adjuvant therapy if indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	Procedure or service furnished without a global surgical package	Rarely used; billing systems may include this placeholder when no global period applies.

CPT 58275: Vaginal Hysterectomy with Vaginal Excision

CPT-58240-PELVIC-EXENTERATION-MULTI-ORGAN-RESECTION

CPT 58240: Pelvic Exenteration for Recurrent or Advanced Cervical Cancer

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

CPT 58270: Vaginal Hysterectomy with Small Bowel Prolapse Repair

CPT-58152-ABDOMINAL-HYSTERECTOMY-URETHRAL-SUSPENSION

CPT 58152: Abdominal Hysterectomy with Urethral Suspension

CPT-58267-VAGINAL-HYSTERECTOMY-WITH-URETHRAL-SUSPENSION

CPT 58267: Vaginal Hysterectomy with Urethral Suspension

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

CPT 58285: Radical Hysterectomy for Cervical Cancer

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

CPT 58150: Abdominal Hysterectomy with Cervix Removal

CPT-58180-ABDOMINAL-HYSTERECTOMY-OPEN-UTERUS-REMOVAL

CPT 58180: Abdominal Hysterectomy, Open Removal of Uterus

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

CPT 58262: Vaginal Hysterectomy with Bilateral Salpingo-Oophorectomy

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

CPT 58210: Radical Abdominal Hysterectomy with Pelvic Lymphadenectomy

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Taxonomy Code	Specialty	Notes
207W00000X	Gynecologic Oncology	Specialists who commonly perform radical or staging hysterectomies with lymphadenectomy.
207VP2900X	Obstetrics & Gynecology	General gynecologic surgeons perform total abdominal hysterectomy procedures.
207L00000X	General Surgery	May be involved when extensive pelvic/abdominal pathology requires general surgical expertise.
207SC0000X	Surgical Oncology	May participate in oncologic cases requiring lymph node dissection and staging.
207K00000X	Gynecology	Practicing gynecologists performing abdominal hysterectomy procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C54.1`	Malignant neoplasm of endometrium	Common indication for total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymph node sampling for staging and treatment.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Indication for radical hysterectomy and lymph node assessment when cervical cancer involves the uterus/cervix.
`D07.1`	Carcinoma in situ of endometrium	May prompt definitive surgical management in select patients.
`N80.0`	Endometriosis of uterus (adenomyosis)	Severe symptomatic disease sometimes managed with hysterectomy when conservative therapy fails.
`N92.0`	Excessive and frequent menstruation with regular cycle	Symptomatic benign indication leading to abdominal hysterectomy when other treatments fail.
`N83.2`	Torsion of ovary, ovarian pedicle	May necessitate oophorectomy at time of hysterectomy if ischemic or necrotic.
`D39.1`	Neoplasm of uncertain behavior of ovary	May require bilateral salpingo-oophorectomy with staging.
`Z90.710`	Acquired absence of cervix	Postoperative status code relevant to documentation after cervix removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99223`	Initial hospital care, typically 70 minutes or more	Preoperative hospital admission and evaluation on the day of major surgery; used by the attending surgeon for inpatient preoperative evaluation.
`58150`	Laparoscopic supracervical hysterectomy, morcellation may be included	An alternative minimally invasive approach; contrasted with open abdominal hysterectomy when laparoscopy is not feasible.
`38792`	Laparotomy, exploration, biopsy(s) (including frozen section(s) when performed)	Performed when intraoperative exploration and biopsies are required in addition to hysterectomy.
`38900`	Lymph node, open, excision (single)	Codes for isolated lymph node excision that may be reported when specific nodes are removed outside the hysterectomy code context.
`99500`	Home visit for postoperative care (example code for illustration)	Postoperative follow-up services in the outpatient/home setting; used for continuity of care after discharge.

Note: If specific institutional or payer rules require distinct coding for lymphadenectomy or additional procedures, those services are coded separately per payer policy and documentation.

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