Summary & Overview
CPT 58270: Vaginal Hysterectomy with Small Bowel Prolapse Repair
CPT code 58270 represents a vaginal hysterectomy removing the uterus and cervix only, performed via a vaginal approach, with concurrent repair of small bowel prolapse into the vaginal canal. It applies when the uterus is normal in size (250 grams or less). This surgical code matters nationally as vaginal hysterectomy with prolapse repair is a common gynecologic procedure affecting surgical practice patterns, facility utilization, and payer reimbursement across inpatient and outpatient surgical settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for this procedure, typical sites of service, and the kinds of benchmarks and policy factors that influence coverage and payment. The publication outlines common billing considerations tied to surgical approach and organ size, explores payer coverage patterns, and summarizes related coding and service-line implications.
The content provides concise guidance on what this code denotes clinically and operationally, highlights areas where policy updates or coverage criteria commonly affect claim adjudication, and identifies data points that payers and providers typically examine for utilization management and quality measurement. Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related codes, and detailed payer-specific reimbursement rates.
Billing Code Overview
CPT code 58270 describes a vaginal hysterectomy with repair of small bowel prolapse. In this procedure the provider surgically removes the uterus and cervix only using a vaginal approach. The procedure specification indicates the uterus is normal in size (weighing 250 grams or less).
Service type: Surgical — Gynecologic Procedure (Vaginal Hysterectomy with Pelvic Organ Prolapse Repair)
Typical site of service: Hospital operating room or ambulatory surgery center, using a vaginal surgical approach
Clinical & Coding Specifications
Clinical Context
A 56-year-old female presents with symptomatic pelvic organ prolapse including vaginal vault enterocele with small bowel prolapse into the vaginal canal, associated pelvic pressure, urinary urgency, and dyspareunia. Conservative measures (pessary, pelvic floor physical therapy) have been attempted without durable relief. Preoperative evaluation includes history and physical, pelvic exam confirming apical prolapse and normal-sized uterus, pelvic ultrasound showing no suspicious adnexal pathology, routine labs, and anesthesia assessment. The surgeon schedules a planned vaginal hysterectomy with repair of enterocele using a vaginal approach (58270). The procedure is performed in an operating room at an outpatient surgical center or hospital same-day surgery unit under general or regional anesthesia. Intraoperative steps include vaginal removal of the uterus and cervix, identification and reduction of the enterocele, reapproximation of the vaginal cuff and support suture repair (e.g., high uterosacral ligament or sacrospinous fixation techniques as indicated), hemostasis, and vaginal cuff closure. Postoperative recovery occurs in the PACU with monitoring for bleeding, urinary retention, and bowel function before discharge with analgesia, activity restrictions, and follow-up for wound and pelvic support evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no other modifier applies |