Summary & Overview
CPT 58275: Vaginal Hysterectomy with Vaginal Excision
CPT code 58275 denotes a vaginal hysterectomy in which the uterus and cervix are removed via a vaginal approach, with partial or complete excision of the vagina. This gynecologic surgical code captures a significant class of operations for benign and malignant conditions affecting the uterus and vagina and is important for surgical coding, utilization monitoring, and payment policy across hospital and ambulatory surgery settings. Nationally, accurate coding of 58275 affects case mix, quality measurement, and reimbursement for gynecologic surgical services.
Key payers commonly included in analyses are 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 scope of services captured by the code. The publication also summarizes common modifiers supplied in the input and outlines which payers are part of the comparative scope. It highlights benchmarks, procedural definitions, and policy-relevant implications for national payers and hospital billing operations. The content is oriented to billing managers, coding specialists, and policy analysts seeking clear, code-level guidance and context for 58275 without state-specific detail.
Billing Code Overview
CPT code 58275 describes a vaginal hysterectomy with partial or complete excision of the vagina. In this procedure, the provider surgically removes the uterus and the cervix through a vaginal approach, and partially or completely excises the vagina as part of the operation.
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Service type: Major gynecologic surgical procedure (vaginal hysterectomy with vaginal excision)
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Typical site of service: Inpatient or outpatient hospital surgical setting or ambulatory surgery center, where gynecologic surgeries are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 48-year-old parous female presents with symptomatic uterine fibroids causing heavy menstrual bleeding and pelvic pressure refractory to medical therapy. After office evaluation including pelvic exam, transvaginal ultrasound, and preoperative assessment, the gynecologic surgeon schedules a planned vaginal hysterectomy with partial vaginectomy for definitive management. The patient is admitted to an ambulatory surgery center or hospital operating room on the day of surgery. Under general or regional anesthesia, the surgeon performs a vaginal approach to remove the uterus and cervix, with appropriate hemostasis and partial vaginal cuff excision. Postoperative recovery includes monitoring in the PACU, analgesia management, discharge instructions for wound and activity restrictions, and a follow-up visit within 2 weeks to assess healing and pathology results.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier appended (default) | Use when no special circumstance modifier applies |
11 | Office or other outpatient visit for an established patient (not a surgical modifier by CMS but listed) | Use in some payer systems to indicate a standard service scenario when required by billing policy |