Summary & Overview
CPT 58285: Radical Hysterectomy for Cervical Cancer
CPT code 58285 denotes a radical hysterectomy with bilateral salpingo-oophorectomy, resection of the parametrium and removal of the upper one-third of the vagina, routinely performed for treatment of cervical cancer. Nationally, this code represents a high-acuity gynecologic oncology surgical service with implications for inpatient surgical capacity, perioperative resource utilization, and oncology care pathways.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The review provides a clinical and billing-oriented overview that helps payers and provider organizations understand coding intent, typical site-of-service expectations, and common billing considerations for high-complexity gynecologic oncology surgery.
Readers will find concise benchmarks for service classification and site-of-care, context on clinical indications and procedural scope, and a summary of common modifiers and payer considerations where available. Data not available in the input is noted where applicable. This summary is intended for national audiences involved in revenue cycle, clinical operations, and payer-policy development related to major gynecologic surgical services.
Billing Code Overview
CPT code 58285 describes a radical hysterectomy with removal of the uterus, fallopian tubes, ovaries, parametrium (including the uterosacral, cardinal, broad, and round ligaments), and the upper one-third of the vagina. The procedure is performed to treat cervical cancer and involves extensive pelvic dissection.
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Service type: Major gynecologic oncologic surgical procedure
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Typical site of service: Inpatient hospital surgical setting
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman with biopsy-confirmed invasive cervical carcinoma presents for definitive surgical management after staging workup. She has completed preoperative evaluation including pelvic MRI and PET-CT showing disease confined to the cervix without gross parametrial extension. The patient undergoes an open radical hysterectomy with bilateral salpingo-oophorectomy and resection of the upper one-third of the vagina; pelvic lymphadenectomy may be performed separately. The typical workflow includes preoperative consent and anesthesia evaluation, perioperative antibiotic prophylaxis, intraoperative radical dissection of the parametrium (uterosacral, cardinal, broad, and round ligaments), removal of the uterus, fallopian tubes, and ovaries, and resection of the vaginal cuff. Postoperative care includes pain control, fluid management, monitoring for bleeding or urinary retention, pathology review for margins and nodal status, and coordination of adjuvant therapy if indicated by final pathology. Typical sites of service are an inpatient hospital operating room or an ambulatory surgery center if clinically appropriate; however, radical hysterectomy for cervical cancer is most commonly performed in an inpatient hospital setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When substantially greater work or complexity than usual for 58285 is documented (e.g., extensive adhesiolysis). |