Summary & Overview
CPT 58353: Thermal Endometrial Ablation Without Hysteroscopy
CPT code 58353 represents thermal endometrial ablation performed without hysteroscopic guidance to treat excessive or abnormal uterine bleeding. Nationally, this code captures a common minimally invasive gynecologic procedure used as an alternative to medical therapy or hysterectomy, with implications for procedure utilization, site-of-service costs, and post-procedure care pathways. Payors commonly covering services associated with this code include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.
Readers will learn the clinical context of the procedure, typical sites of service (ambulatory surgical centers, hospital outpatient departments, and select office settings), and common billing considerations tied to this service line. The publication summarizes benchmarks for utilization and reimbursement where available, highlights policy and coverage trends relevant to endometrial ablation, and outlines coding and billing issues that affect claims adjudication. Data not available in the input will be noted as such in the detailed sections. The analysis is intended for national audiences including providers, payors, and policy analysts interested in gynecologic procedural coding and payment patterns.
Billing Code Overview
CPT code 58353 describes a thermal endometrial ablation performed without hysteroscopic guidance, in which the provider removes or destroys the lining of the uterus using a device that produces heat. The procedure is performed to stop or reduce excessive or abnormal uterine bleeding.
Service type: Surgical/gynecologic procedure (endometrial ablation)
Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be performed in-office when clinically appropriate
Clinical & Coding Specifications
Clinical Context
A typical patient is a premenopausal or perimenopausal woman presenting with heavy, prolonged, or irregular uterine bleeding unresponsive to medical therapy (eg, hormonal management, tranexamic acid). She often reports heavy menstrual bleeding causing anemia and impaired quality of life. Evaluation includes history, pelvic examination, pregnancy test, transvaginal ultrasound to exclude structural lesions, and endometrial sampling as indicated. After counseling about alternatives (medical therapy, levonorgestrel IUD, myomectomy, hysterectomy) and confirming no contraindications (suspected endometrial hyperplasia, active pelvic infection, desire for future fertility), the provider schedules a thermal endometrial ablation.
Procedure workflow: The patient presents to an ambulatory surgery center or hospital outpatient department. Preoperative assessment and informed consent are completed. Under conscious sedation or general anesthesia, the provider places a uterine sound and cervical dilator if necessary, inserts the thermal ablation device transcervically, and activates the device to thermally destroy the endometrial lining without hysteroscopic visualization. Hemostasis and recovery follow; the patient is discharged same day with postoperative instructions and follow-up arranged to assess bleeding outcomes and complications such as cramping, bleeding, or infection. Typical indications coded for this service include heavy menstrual bleeding and abnormal uterine bleeding not related to pregnancy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
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