Summary & Overview
CPT 58550: Laparoscopic-Assisted Vaginal Hysterectomy, Normal-Size Uterus
CPT code 58550 represents a laparoscopic-assisted vaginal hysterectomy for removal of the uterus and cervix when the uterus is normal in size (250 grams or less). This minimally invasive gynecologic procedure matters nationally because it is a common surgical option for benign and select gynecologic conditions, impacting hospital outpatient and ambulatory surgery utilization, perioperative coding consistency, and payer coverage policies across commercial and public programs.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the procedure type and typical sites of service, coding scope for a normal-size uterus, and an overview of what to expect in payer coverage discussions. The publication summarizes benchmarks and reimbursement considerations, highlights relevant policy updates that affect utilization and authorization, and clarifies coding boundaries for this laparoscopic-assisted vaginal approach versus other hysterectomy techniques.
This national-level summary is intended to help billing specialists, practice managers, and policy analysts understand where CPT code 58550 fits within gynecologic surgical coding, payer landscapes, and facility settings. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 58550 describes a laparoscopic-assisted vaginal hysterectomy for a normal-size uterus (250 grams or less). In this procedure, the provider removes the uterus and cervix through the vagina while using a laparoscope to transect the upper uterine attachments.
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Service type: Minimally invasive gynecologic surgery (laparoscopic-assisted vaginal hysterectomy)
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Typical site of service: Hospital outpatient department or ambulatory surgical center, with the vaginal removal portion of the procedure performed in the operating room setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 42-year-old woman with symptomatic uterine fibroids and heavy menstrual bleeding refractory to medical management. She presents for preoperative evaluation after conservative therapies (hormonal therapy, iron supplementation) failed to control symptoms. Diagnostic workup includes pelvic ultrasound confirming a uterus of normal size (estimated ≤250 g), routine labs, and anesthesia clearance. The planned procedure is a total laparoscopic hysterectomy with removal of the cervix via the vaginal route (58550). The clinical workflow includes preoperative counseling and informed consent, preoperative antibiotic prophylaxis, general anesthesia with laparoscopic abdominal access, laparoscopic transection of the utero-ovarian and broad ligament attachments, securing pedicles (uterine arteries), mobilization of the uterus, and removal of the uterus and cervix through the vagina. Intraoperative steps may include hemostasis, inspection of adnexa, and possible concomitant procedures if indicated. Postoperative recovery typically occurs in an ambulatory surgical center or hospital short-stay setting with routine postoperative instructions and follow-up for wound and symptom assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default when no specific modifier applies |