Summary & Overview
CPT 58290: Vaginal Hysterectomy for Enlarged Uterus (>250 g)
CPT code 58290 represents a vaginal hysterectomy with removal of the uterus and cervix for an enlarged uterus (operative weight >250 g), often performed for symptomatic fibroids. This procedure is a common gynecologic operation with important implications for surgical resource utilization, site-of-service planning, and payer reimbursement across the U.S. health system.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service delivery for CPT code 58290, national-level considerations for where the procedure is performed, and what metrics are typically examined in benchmarking and policy reviews for surgical gynecology. The publication highlights typical site-of-service patterns (hospital operating rooms and ambulatory surgery centers), major clinical drivers (eg, fibroids producing enlarged uterine size), and common billing characteristics associated with this code.
This summary prepares clinicians, billing professionals, and policy stakeholders to understand CPT code 58290 in a national context, including where to look for reimbursement guidance, operational impacts on surgical scheduling, and the clinical scenarios that most frequently generate use of this code. Data not available in the input: specific payer rate tables, associated ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 58290 describes a surgical procedure in which the physician removes the uterus and cervix using a vaginal approach. The procedure is indicated when the uterus is larger than normal, typically due to conditions such as fibroids, with an operative uterine weight greater than 250 g.
Service type: Surgical — Vaginal Hysterectomy for Enlarged Uterus
Typical site of service: Hospital operating room or ambulatory surgery center using a vaginal surgical approach
Clinical & Coding Specifications
Clinical Context
A 46-year-old parous woman with symptomatic uterine fibroids presents with heavy menstrual bleeding, pelvic pressure, and anemia despite medical therapy. Imaging (pelvic ultrasound or MRI) demonstrates an enlarged, irregularly contoured uterus with multiple intramural fibroids and an estimated uterine weight >250 g. After counseling on surgical options, the patient elects a vaginal hysterectomy. Preoperative evaluation includes history and physical, labs (CBC, Type and Screen), anesthesia assessment, and informed consent. The procedure is performed under general or regional anesthesia in an operating room or ambulatory surgery center equipped for gynecologic surgery. The surgeon removes the uterus and cervix using a vaginal approach; intraoperative steps commonly include ureteral identification as needed, clamping and ligation of the uterine vessels, removal of the specimen through the vaginal canal (morcellation or bivalving may be required for large uteri), and inspection for hemostasis. Postoperative care includes recovery room monitoring, pain control, prophylactic antibiotics as indicated, and instructions for activity limitation and follow-up. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special condition applies and the procedure is billed normally. |