Summary & Overview
CPT 58543: Laparoscopic Subtotal Hysterectomy for Enlarged Uterus (>250 g)
Headline: CPT code 58543: Laparoscopic Subtotal Hysterectomy for Enlarged Uterus — Clinical and Payer Overview
Lead: CPT code 58543 designates a laparoscopic subtotal (supracervical) hysterectomy performed for an enlarged uterus—commonly from fibroids—where the uterine weight exceeds 250 grams and the cervix and adnexa are preserved. This procedure is an important surgical option in gynecologic care due to its role in managing symptomatic fibroid disease while retaining the cervix and ovaries when clinically appropriate.
Why it matters nationally: Use of minimally invasive hysterectomy techniques affects surgical outcomes, resource utilization, and payer reimbursement strategies across settings. CPT code 58543 captures a specific clinical scenario (enlarged uterus >250 g) that can influence operative complexity, operative time, and site-of-service decisions.
Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides clinical context for CPT code 58543, outlines typical sites of service and procedure intent, and summarizes the payer landscape covered in the analysis. Where available, readers will find benchmarking and policy updates related to coverage and coding practices, plus procedural considerations for claims submission. If specific data elements were not provided in the source, the publication notes that those fields are not available.
Billing Code Overview
CPT code 58543 describes a laparoscopic subtotal (supracervical) hysterectomy performed when the uterus is enlarged—typically due to fibroids—resulting in a uterine weight greater than 250 grams. In this procedure the uterus is removed via laparoscopy while the cervix and the fallopian tubes and ovaries are left in place.
Service type: Laparoscopic gynecologic surgery — subtotal hysterectomy for enlarged uterus (fibroid-related)
Typical site of service: Hospital outpatient surgical suite or ambulatory surgery center, where laparoscopic gynecologic procedures are commonly performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a premenopausal woman in her 40s presenting with symptomatic uterine fibroids causing heavy menstrual bleeding, pelvic pressure, and anemia. Conservative measures (medical therapy, levonorgestrel IUD, or tranexamic acid) were attempted or are contraindicated, and imaging (transvaginal ultrasound or pelvic MRI) demonstrates a uterus enlarged by fibroids with estimated uterine weight >250 g. The surgical plan is a laparoscopic supracervical hysterectomy (58543) performed under general anesthesia. The clinical workflow includes preoperative evaluation (history, physical, CBC, pregnancy test if of reproductive potential), informed consent discussing removal of the uterine corpus while retaining the cervix and ovaries/tubes if indicated, perioperative prophylactic antibiotics, laparoscopic entry (umbilical or alternative port), uterine vessel sealing, division of the corpus from the cervix, specimen removal (morcellation or mini-laparotomy if needed), hemostasis, and postoperative recovery with instructions for activity, pain control, and follow-up. Typical site of service is an ambulatory surgery center or hospital operating room. Common intraoperative considerations include management of large fibroids that may necessitate morcellation (if appropriate), conversion to open hysterectomy if visualization or bleeding is uncontrolled, and documentation of uterine weight >250 g in the operative note.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |