CPT 58548 Laparoscopic Radical Hysterectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58548: Laparoscopic Radical Hysterectomy with BSO and Pelvic Lymphadenectomy

CPT code 58548 denotes a laparoscopic radical hysterectomy with bilateral salpingo-oophorectomy and comprehensive pelvic lymphadenectomy, with some para‑aortic node removal. This code represents a complex, oncologic gynecologic surgical procedure used in the management of invasive uterine or cervical malignancies and other conditions requiring extensive uterine and nodal resection. Nationally, it is important because it captures care that involves multidisciplinary surgical teams, significant operative resources, and downstream oncologic treatment planning.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical and billing context for the procedure, typical sites of service, and common billing considerations associated with major laparoscopic gynecologic oncology operations. The publication offers benchmarks and payment context where available, outlines policy and documentation factors that commonly affect coding and claims adjudication, and summarizes clinical indications relevant to assigning the code. Data not available in the input will be noted as such. This resource is intended for billing professionals, revenue cycle managers, and clinical staff seeking a concise reference for CPT code 58548.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare58548CPTgynecologic-surgerylaparoscopic-hysterectomyradical-hysterectomylymphadenectomyoncology-surgery

Billing Code Overview

CPT code 58548 describes a laparoscopic radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, including excision of the parametrium, cardinal and uterosacral ligaments, and removal of pelvic lymph nodes on both sides with partial removal of para‑aortic nodes. This procedure is a major gynecologic oncologic operation.

Service type: Major minimally invasive gynecologic surgery (laparoscopic radical hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection)
Typical site of service: Hospital operating room or ambulatory surgery center with full surgical oncology support

Clinical & Coding Specifications

Clinical Context

A 54-year-old woman with newly diagnosed endometrial carcinoma is scheduled for a planned laparoscopic total hysterectomy with bilateral salpingo-oophorectomy and pelvic and limited para‑aortic lymphadenectomy. Preoperative workup includes pelvic MRI, endometrial biopsy confirming Grade 1–2 endometrioid adenocarcinoma, routine labs, anesthesia evaluation, and informed consent documenting oncologic staging procedure. On the day of surgery the patient undergoes general endotracheal anesthesia in an ambulatory surgery center or hospital operating room. The surgeon places laparoscopic ports, mobilizes the uterus, fallopian tubes, and ovaries, divides the uterosacral and cardinal ligaments, resects the parametrial tissue, and conducts systematic pelvic lymph node dissection bilaterally with selective removal of para‑aortic nodes for staging and clearance. Specimens are sent to pathology. Postoperative recovery includes PACU monitoring, pain control, venous thromboembolism prophylaxis, and discharge planning or inpatient admission based on intraoperative findings and patient status.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work, time, or complexity substantially exceeds usual for `58548` (document justification).

CPT 58550: Laparoscopic-Assisted Vaginal Hysterectomy, Normal-Size Uterus

CPT-58575-LAPAROSCOPIC-TOTAL-HYSTERECTOMY-BSO-WITH-OMENTECTOMY-FOR-CANCER

CPT 58575: Laparoscopic Total Hysterectomy with BSO and Omentectomy for Cancer

CPT-58552-VAGINAL-HYSTERECTOMY-WITH-LAPAROSCOPIC-ASSISTANCE

CPT 58552: Vaginal Hysterectomy With Laparoscopic Assistance

CPT-58563-HYSTEROSCOPIC-ENDOMETRIAL-ABLATION

CPT 58563: Hysteroscopic Endometrial Ablation

CPT-58554-VAGINAL-HYSTERECTOMY-LAPAROSCOPIC-ASSISTED-LARGE-UTERUS

CPT 58554: Vaginal Hysterectomy with Laparoscopic Assistance for Large Uterus

CPT-58542-LAPAROSCOPIC-SUBTOTAL-HYSTERECTOMY-SUPRACERVICAL

CPT 58542: Laparoscopic Subtotal (Supracervical) Hysterectomy

CPT-58571-LAPAROSCOPIC-TOTAL-HYSTERECTOMY-UTERUS-250G-OR-LESS

CPT 58571: Laparoscopic Total Hysterectomy for Uterus 250 g or Less

CPT-58543-LAPAROSCOPIC-SUBTOTAL-HYSTERECTOMY-ENLARGED-UTERUS

CPT 58543: Laparoscopic Subtotal Hysterectomy for Enlarged Uterus (>250 g)

CPT-58565-HYSTEROSCOPIC-FALLOPIAN-TUBE-STERILIZATION-COIL-IMPLANT

CPT 58565: Hysteroscopic Fallopian Tube Sterilization with Coil Implants

CPT-58546-LAPAROSCOPIC-MYOMECTOMY-MULTIPLE-OR-MASSIVE-FIBROIDS

CPT 58546: Laparoscopic Myomectomy for Multiple or Large Fibroids

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Taxonomy Code	Specialty	Notes
`208D00000X`	Obstetrics & Gynecology	General gynecologic surgeons performing hysterectomy and adnexal surgery.
`2084P0800X`	Gynecologic Oncology	Specialists who perform oncologic staging, pelvic and para‑aortic lymphadenectomy.
`208000000X`	General Surgery	General surgeons who may assist or perform complex pelvic resections in multidisciplinary cases.
`207L00000X`	Obstetrics & Gynecology Hospitalist	Hospital-based gynecologic surgeons managing perioperative inpatient care.
`363LF0000X`	Surgical Oncology	Surgical oncologists involved in extended nodal dissections and complex cancer resections.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C54.1`	Malignant neoplasm of endometrium	Primary indication for oncologic hysterectomy with staging lymphadenectomy.
`C56.9`	Malignant neoplasm of ovary, unspecified	When adnexal malignancy necessitates removal of ovaries and staging nodes.
`D07.1`	Carcinoma in situ of endometrium	Premalignant lesion that may lead to definitive hysterectomy and node assessment in selected patients.
`N91.0`	Primary amenorrhea	Rarely an indication for hysterectomy; included when definitive uterine removal is clinically indicated.
`N80.0`	Endometriosis of uterus (adenomyosis)	Benign indication for hysterectomy with adnexal removal when symptomatic and refractory to medical therapy.
`D25.9`	Leiomyoma of uterus, unspecified	Common benign indication for hysterectomy when medical/conservative management fails.
`N95.0`	Postmenopausal bleeding	Symptom prompting evaluation that may result in hysterectomy for underlying malignancy or benign disease.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58720`	Salpingectomy, partial or complete, unilateral or bilateral, laparoscopic	May be billed if separate laparoscopic salpingectomy is performed distinct from the hysterectomy portion when documentation supports separate service.
`58260`	Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(ies)	Alternate surgical approach; used when hysterectomy is performed vaginally instead of laparoscopically.
`38792`	Laparoscopy, surgical; with para-aortic lymphadenectomy	When para‑aortic node dissection is more extensive and reported separately in some operative coding structures; relates to staging component.
`38100`	Lymphadenectomy, pelvic, unilateral	When separate coding for pelvic lymph node dissection is required or performed in a way that may be reported distinctly depending on documentation and payer rules.
`88309`	Surgical pathology, gross and microscopic examination, higher complexity (per specimen)	Used for pathology processing and examination of uterine and nodal specimens removed during `58548`.
`99231`	Subsequent hospital care, typically 15 minutes per day	Postoperative inpatient evaluation following the procedure during the global period when applicable.

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