Summary & Overview
CPT 58546: Laparoscopic Myomectomy for Multiple or Large Fibroids
CPT code 58546 denotes a laparoscopic myomectomy for removal of five or more uterine fibroids or any number of fibroids weighing more than 250 g. The code captures a specific surgical complexity level within minimally invasive gynecologic procedures and is used to document and bill for higher-volume or higher-mass excisions of fibroids. Nationally, accurate coding for procedures like 58546 affects surgical quality measurement, resource allocation, and facility reimbursement for gynecologic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for laparoscopic myomectomy, common sites of service, and the administrative implications of using 58546 versus other myomectomy codes. The publication summarizes typical billing practice considerations, common modifiers used in practice (input provided), and where data was available versus where input data is missing.
This report is intended for a national audience of clinicians, coding professionals, and health plan administrators seeking concise guidance on the clinical scope of CPT code 58546, how it aligns with surgical practice patterns, and what benchmark and policy topics to consider when evaluating claims or coverage for laparoscopic myomectomy.
Billing Code Overview
CPT code 58546 describes a laparoscopic myomectomy in which the provider excises fibroid tumors of the uterus and removes a total of five or more fibroid tumors or any number of fibroid tumors that have a total weight of more than 250 g. This procedure is a minimally invasive gynecologic surgery performed through a laparoscope.
Service type: Surgical — Laparoscopic myomectomy
Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 38-year-old woman presents with symptomatic uterine fibroids causing heavy menstrual bleeding, pelvic pressure, and anemia despite medical therapy. Imaging (transvaginal ultrasound and pelvic MRI) demonstrates multiple intramural and subserosal leiomyomas, with surgical planning indicating laparoscopic myomectomy. The surgeon plans excision of five or more fibroids and anticipates aggregate specimen weight greater than 250 g, consistent with 58546. The typical clinical workflow includes preoperative evaluation (history, physical, labs, cross-match as needed), informed consent, anesthesia evaluation, perioperative antibiotics, laparoscopic removal of fibroids with hemostasis (electrosurgical or energy device), restoration of uterine integrity, specimen retrieval, and postoperative monitoring in the ambulatory surgery center or hospital depending on anesthesia and comorbidities. Postoperative pathology confirms leiomyoma (benign smooth muscle tumor). Typical site of service is an operating room in an ambulatory surgery center or hospital inpatient/overnight observation when indicated. Service type: operative laparoscopic gynecologic surgery (laparoscopic myomectomy).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds usual for 58546 due to extensive adhesiolysis, unexpected complexity, or prolonged operative time documented in the report. |