CPT 58210 Radical Abdominal Hysterectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58210: Radical Abdominal Hysterectomy with Pelvic Lymphadenectomy

CPT code 58210 denotes a radical abdominal hysterectomy with removal of the uterus and cervix including the parametrium, often combined with partial or complete vaginectomy, bilateral pelvic lymphadenectomy, para‑aortic lymph node biopsy, and possible removal of fallopian tubes and ovaries. This code captures a high‑acuity, oncologic gynecologic surgical procedure that is central to management of certain cervical and other gynecologic malignancies; it has implications for hospital resource use, surgical quality measures, and payer reimbursement policies nationally. Key payers in coverage and reimbursement discussions 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 kinds of billing considerations associated with radical hysterectomy and extensive lymph node surgery. The publication summarizes common modifiers reported with this service, situates the code within inpatient surgical care, and highlights what to review in payer policies and prior‑authorization rules. It is intended to inform billing, coding compliance, and operational planning for hospitals and surgical practices involved in major gynecologic oncology cases, and to provide a starting point for comparing payer-specific requirements and coverage language. Data not available in the input for detailed payer-specific rates, associated taxonomies, and ICD‑10 diagnosis mappings.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare58210CPTgynecologic-surgeryradical-hysterectomypelvic-lymphadenectomyinpatient-surgeryoncologic-surgery

Billing Code Overview

CPT code 58210 describes a radical abdominal hysterectomy, in which the provider removes the uterus and cervix including the parametrium via an abdominal incision. The procedure may also include removal of all or part of the vagina, complete pelvic lymphadenectomy on both right and left sides, biopsy of para‑aortic lymph nodes, and removal of part or all of the fallopian tubes and ovaries.

Service Type: Major open gynecologic oncologic surgery (radical hysterectomy with pelvic lymphadenectomy)

Typical Site of Service: Inpatient hospital — operating room with postoperative inpatient stay

Clinical & Coding Specifications

Clinical Context

A 52-year-old woman presents with persistent abnormal vaginal bleeding, pelvic pain, and a pelvic mass found on imaging. Biopsy reveals early-stage cervical carcinoma with parametrial involvement, and multidisciplinary tumor board consensus recommends definitive surgical management. The patient is scheduled for a radical abdominal hysterectomy with bilateral pelvic lymphadenectomy and possible para-aortic lymph node sampling. Preoperative workup includes history and physical, cross-sectional pelvic imaging (MRI/CT), anesthesia evaluation, informed consent discussing potential bilateral salpingo-oophorectomy, blood type and screen, and scheduling for an inpatient stay. Intraoperative workflow: midline or Pfannenstiel abdominal incision, resection of uterus and cervix with parametrium, en bloc removal of part of the upper vagina as indicated, pelvic lymph node dissection bilaterally, selective para-aortic node biopsy if indicated, and possible unilateral or bilateral oophorectomy. Postoperative care includes inpatient monitoring for hemodynamic stability, pain control, venous thromboembolism prophylaxis, early ambulation, drain management if placed, pathology review of uterus and nodes, and scheduling adjuvant therapy if pathology indicates need for radiation or chemotherapy.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical difficulty substantially exceeds typical for `58210`.

CPT 58150: Abdominal Hysterectomy with Cervix Removal

CPT-58294-VAGINAL-HYSTERECTOMY-ENLARGED-UTERUS-WITH-BOWEL-REPAIR

CPT 58294: Vaginal Hysterectomy for Enlarged Uterus with Bowel Repair

CPT-58290-VAGINAL-HYSTERECTOMY-ENLARGED-UTERUS

CPT 58290: Vaginal Hysterectomy for Enlarged Uterus (>250 g)

CPT-58200-ABDOMINAL-HYSTERECTOMY-WITH-LYMPHADENECTOMY

CPT 58200: Abdominal Hysterectomy with Lymphadenectomy

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

CPT 58262: Vaginal Hysterectomy with Bilateral Salpingo-Oophorectomy

CPT-58291-VAGINAL-TOTAL-HYSTERECTOMY-BILATERAL-SALPINGO-OOPHORECTOMY-ENLARGED-UTERUS

CPT 58291: Vaginal Total Hysterectomy with Bilateral Salpingo-Oophorectomy for Enlarged Uterus

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

CPT 58280: Vaginal Hysterectomy with Enterocele Repair

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

CPT 58240: Pelvic Exenteration for Recurrent or Advanced Cervical Cancer

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Taxonomy Code	Specialty	Notes
208100000X	Obstetrics & Gynecology	General OB/GYN surgeons frequently perform abdominal hysterectomies and radical procedures in collaboration with gynecologic oncologists.
208H00000X	Gynecologic Oncology	Specialists who most commonly perform radical hysterectomy with lymphadenectomy for cervical and other gynecologic malignancies.
207L00000X	General Surgery	May participate for complex pelvic resections or when colorectal or urologic involvement requires multidisciplinary approach.
2080P0207X	Reproductive Endocrinology/Infertility	Rarely involved; included for completeness when ovarian function or preservation is a consideration.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C53.1`	Malignant neoplasm of endocervix	Common indication for radical hysterectomy with lymphadenectomy when invasive cervical cancer involves the cervix.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Used when cervical cancer is diagnosed but specific subsite not documented; radical hysterectomy may be indicated depending on stage.
`C56.9`	Malignant neoplasm of ovary, unspecified	May prompt concomitant oophorectomy or staging procedures during radical pelvic surgery.
`D07.1`	Carcinoma in situ of endocervix	In select high-risk or extensive cases, more radical surgical approaches may be considered.
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Presenting symptom that can lead to diagnostic workup and eventual hysterectomy if malignancy or refractory disease diagnosed.
`C79.2`	Secondary malignant neoplasm of ovary	Indicates metastatic disease to ovary; may influence extent of resection and lymph node sampling.
`R87.619`	Abnormal cytology of cervix, unspecified	Screening/diagnostic finding that often precedes biopsy and definitive surgical treatment for confirmed malignancy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`38746`	Laparoscopy, surgical; para-aortic lymphadenectomy	Performed when para-aortic nodes are sampled or removed laparoscopically as part of staging; may precede or accompany `58210`.
`38571`	Lymphadenectomy, pelvic; unilateral	Represents pelvic lymph node dissection when reported separately or when extent differs from radical hysterectomy coding; bilateral dissections may be reported with bilateral-specific codes per payer rules.
`58943`	Oophorectomy, partial or total, unilateral or bilateral	Performed if one or both ovaries are removed during the radical hysterectomy; may be reported separately depending on payer bundling rules.
`49000`	Exploratory laparotomy, exploratory abdominal surgery	May be reported if an extensive exploratory procedure beyond the targeted radical hysterectomy is required.
`51702`	Cystourethroscopy, with or without irrigation and/or injection	May be performed intraoperatively if urinary tract assessment or repair is needed due to proximity of surgery to bladder/ureter.
`99100`	Anesthesia for procedures on lower abdomen; major procedure	Represents anesthesia services commonly billed alongside major abdominal gynecologic surgery; reported by anesthesia providers rather than surgeon.

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