CPT 58260 Vaginal Hysterectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58260: Vaginal Hysterectomy, Uterus and Cervix Only

CPT code 58260 represents a vaginal hysterectomy involving surgical removal of the uterus and cervix only when the uterus is normal in size (≤250 g). This gynecologic operative code is commonly used for benign indications where a vaginal approach is feasible and may be performed in inpatient settings or ambulatory surgical centers. Nationally, vaginal hysterectomy remains an important surgical option due to shorter recovery times and avoidance of abdominal incisions for appropriately selected patients. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical settings for use, discussion of common billing considerations, and benchmarking content where available. The publication outlines how CPT code 58260 is categorized, typical service lines, and which clinical scenarios align with a vaginal-only hysterectomy for a normal-sized uterus. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 58260 describes a vaginal hysterectomy with removal of the uterus and cervix only when the uterus is normal in size (weighing 250 g or less). The procedure is performed through a vaginal surgical approach and does not include removal of additional reproductive structures.

Service type: Surgical – Gynecologic Procedure

Typical site of service: Inpatient or Ambulatory Surgical Center (vaginal operative suite)

Clinical & Coding Specifications

Clinical Context

A 46-year-old female presents with symptomatic uterine fibroids causing heavy menstrual bleeding and pelvic pressure. Conservative management failed and she elects definitive surgical management. The surgeon schedules a 58260 — vaginal hysterectomy for removal of the uterus and cervix only; preoperative evaluation confirms a uterus of normal size (≤250 g) and no need for radical resection. Typical workflow: preoperative clinic visit with history, pelvic exam, labs and anesthesia evaluation; informed consent documenting indication and approach; perioperative prophylactic antibiotics and venous thromboembolism prevention; vaginal hysterectomy performed under regional or general anesthesia with ligation of uterine vessels and removal of uterus and cervix via the vaginal canal; postoperative recovery in ambulatory or inpatient setting depending on comorbidities and intraoperative course; discharge with standard post-hysterectomy instructions and follow-up visit within 2–6 weeks. Typical site of service: hospital operating room or ambulatory surgery center. Service type: surgical — major gynecologic procedure.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity substantially exceeds typical for `58260` (document rationale).

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

CPT 58280: Vaginal Hysterectomy with Enterocele Repair

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

CPT 58180: Abdominal Hysterectomy, Open Removal of Uterus

CPT-58152-ABDOMINAL-HYSTERECTOMY-URETHRAL-SUSPENSION

CPT 58152: Abdominal Hysterectomy with Urethral Suspension

CPT-58263-VAGINAL-HYSTERECTOMY-BILATERAL-SALPINGO-OOPHORECTOMY-ENTEROCELE-REPAIR

CPT 58263: Vaginal Hysterectomy with Bilateral Salpingo-Oophorectomy and Enterocele Repair

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

CPT 58294: Vaginal Hysterectomy for Enlarged Uterus with Bowel Repair

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

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

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

CPT 58292: Vaginal Hysterectomy with BSO and Small Bowel Repair

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

CPT 58285: Radical Hysterectomy for Cervical Cancer

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Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology	Primary specialty performing vaginal hysterectomy.
207VR0400X	Gynecologic Oncology	Manages complex gynecologic disease; may perform hysterectomy for oncologic indications.
207L00000X	Family Medicine	May perform in select settings when credentialed for gynecologic surgery.
363A00000X	Anesthesiology	Provides anesthesia services during `58260`.
174400000X	Surgery - General	May be involved in multidisciplinary cases or when gynecologic surgeons unavailable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N92.0`	Excessive and frequent menstruation with regular cycle	Common indication for hysterectomy when conservative measures fail.
`D25.9`	Leiomyoma of uterus, unspecified	Uterine fibroids are a frequent reason for vaginal hysterectomy when symptomatic.
`N80.0`	Endometriosis of uterus (adenomyosis)	Adenomyosis can cause pain and bleeding leading to hysterectomy.
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Symptom-driven indication for definitive surgical management.
`N83.2`	Rupture of ovarian cyst	May be associated or require adnexal procedures at time of hysterectomy.
`N76.0`	Acute vaginitis	Concomitant infections are assessed and managed; active infection may alter timing of surgery.
`C56.9`	Malignant neoplasm of ovary, unspecified	When gynecologic malignancy requires hysterectomy as part of staging or treatment (note: radical procedures may be indicated).
`N91.1`	Secondary amenorrhea	In select cases with structural disease, hysterectomy may be considered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57170`	Destruction of submucosal lesion(s) of uterus, any method (eg, hysteroscopic)	Preoperative hysteroscopic procedures to manage intrauterine pathology prior to hysterectomy when performed.
`57454`	Hysteroscopy, diagnostic with sampling (biopsy)	Used preoperatively for evaluation of abnormal uterine bleeding or focal lesions prior to `58260`.
`58661`	Laparoscopy, surgical, with removal of adnexal structures (eg, oophorectomy, salpingectomy)	Performed alongside hysterectomy when adnexal removal is indicated during same operative session (may be laparoscopic-assisted).
`58740`	Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)	Removal of one or both fallopian tubes when performed with hysterectomy.
`59925`	Removal of implanted materials (eg, vaginal mesh)	Occasionally required if prior pelvic surgery complications are encountered during hysterectomy.

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