CPT code 58291 represents a vaginal total hysterectomy with bilateral salpingo-oophorectomy performed for an enlarged uterus—commonly due to fibroids—where uterine weight exceeds 250 g. This major gynecologic surgical code signals comprehensive removal of the uterus, cervix, fallopian tubes, and ovaries through a vaginal approach. Nationally, this code matters because it reflects management of symptomatic uterine fibroid disease, impacts surgical setting and resource use, and informs coverage, prior-authorization, and payment policies across payers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 58291, common sites of service, and the typical service type associated with the procedure. The publication summarizes reimbursement benchmarks where available, highlights recent policy and coding guidance relevant to vaginal hysterectomy for enlarged uteri, and outlines billing considerations and documentation elements that affect claim adjudication. The objective is to provide clinicians, coders, and policy professionals with a clear, national-level reference on the clinical intent and administrative implications of CPT code 58291.