CPT 58561 Hysteroscopic Myomectomy Reimbursement | OpenPayer

Summary & Overview

CPT 58561: Hysteroscopic Myomectomy, Intracavitary Fibroid Removal

CPT code 58561 denotes hysteroscopic myomectomy: removal of intracavitary uterine leiomyomata (fibroids) under direct hysteroscopic visualization. This procedure is a commonly utilized minimally invasive option for symptomatic intracavitary fibroids and is clinically significant for preserving uterine anatomy while addressing bleeding, infertility, or bulk symptoms. Nationally, coding accuracy for hysteroscopic myomectomy affects surgical quality metrics, facility utilization, and payer coverage determinations.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and sites of service, common billing modifiers flagged for review, and what to expect in payer coverage considerations. The publication summarizes typical billing practices, related procedural coding considerations, and where stakeholders often focus audits and medical necessity reviews.

This summary equips clinicians, coding professionals, and policy analysts with the essential framing of CPT code 58561, clarifying why correct CPT coding matters for procedural reporting, reimbursement pathways, and alignment with quality measurement in gynecologic surgery. Data not available in the input for some specific benchmarks and payer policy details.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare58561CPThysteroscopic myomectomygynecologyoperative hysteroscopysurgical codingfibroid removalambulatory surgery

Billing Code Overview

CPT code 58561 describes a surgical procedure in which the provider removes uterine leiomyomata (fibroids) using a hysteroscope. The procedure involves transcervical access with direct visualization of the uterine cavity to excise or morcellate intracavitary fibroids.

Service type: Hysteroscopic myomectomy (operative hysteroscopy)
Typical site of service: Ambulatory surgery center or hospital outpatient department; may also be performed in inpatient settings depending on clinical complexity and patient factors.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 38-year-old woman presents with heavy menstrual bleeding, pelvic pressure, and confirmed submucosal uterine fibroids on transvaginal ultrasound and diagnostic hysteroscopy. Conservative medical therapy failed to control symptoms. The gynecologist schedules an operative hysteroscopic myomectomy to remove intracavitary leiomyomata. On the day of service, the patient undergoes preoperative evaluation, informed consent, and general anesthesia in an ambulatory surgery center. The provider uses a hysteroscope with operative instruments to visualize the uterine cavity and resect or morcellate fibroid tissue. Intraoperative findings, estimated blood loss, number and size of fibroids removed, and any complications are documented. The workflow includes same-day recovery, discharge instructions addressing bleeding and infection signs, and a postoperative follow-up visit to assess symptom improvement and healing.

Coding Specifications

Modifier	Description	When to Use
`51`	Multiple procedures	Use when additional distinct procedures are billed with `58561` during the same operative session and payer permits multiple procedure billing.
`52`

CPT 58555: Diagnostic Hysteroscopy, Uterine Cavity Inspection

CPT-58545-LAPAROSCOPIC-MYOMECTOMY-1-TO-4-FIBROIDS-UP-TO-250G

CPT 58545: Laparoscopic Myomectomy, 1–4 Fibroids (≤250 g)

CPT-58560-HYSTEROSCOPIC-SEPTUM-RESECTION

CPT 58560: Hysteroscopic Resection of Intrauterine Septum

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

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

CPT-58559-HYSTEROSCOPIC-LYSIS-OF-INTRAUTERINE-ADHESIONS

CPT 58559: Hysteroscopic Lysis of Intrauterine Adhesions

CPT-58558-HYSTEROSCOPIC-ENDOMETRIAL-BIOPSY-POLYPECTOMY

CPT 58558: Hysteroscopic Endometrial Biopsy and Polypectomy

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

CPT 58554: Vaginal Hysterectomy with Laparoscopic Assistance for Large Uterus

CPT-58578-LAPAROSCOPIC-UTERINE-PROCEDURE-UNSPECIFIED

CPT 58578: Laparoscopic Uterine Procedure, Unspecified

CPT-58542-LAPAROSCOPIC-SUBTOTAL-HYSTERECTOMY-SUPRACERVICAL

CPT 58542: Laparoscopic Subtotal (Supracervical) Hysterectomy

CPT-58579-UNLISTED-HYSTEROSCOPY-UTERINE-PROCEDURE

CPT 58579: Unlisted Hysteroscopy Procedure of the Uterus

Showing 1–10 of 25

Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology	General gynecologists commonly perform hysteroscopic myomectomy.
207VR0400X	Reproductive Endocrinology/Infertility	REI specialists perform operative hysteroscopy when fertility preservation is a concern.
207VP0122X	Gynecologic Oncology	Gynecologic oncologists manage complex uterine masses and may perform operative hysteroscopy when malignancy concern exists.
208100000X	Family Medicine	Family physicians with procedural training in OB/GYN in some settings may perform hysteroscopic procedures.
363L00000X	Ambulatory Surgery Facility	Facilities providing outpatient gynecologic surgical services; listed as a practice location taxonomy when applicable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N92.0`	Excessive and frequent menstruation with regular cycle	Heavy menstrual bleeding from submucosal fibroids prompting hysteroscopic myomectomy.
`D25.0`	Submucosal leiomyoma of uterus	Primary indication for hysteroscopic removal of intracavitary fibroids.
`D25.1`	Intramural leiomyoma of uterus	Intramural fibroids that may distort the cavity; hysteroscopic approach considered when submucosal component exists.
`D25.9`	Leiomyoma of uterus, unspecified	Used when fibroid location not further specified; may be applied when coding documents leiomyoma without exact subtype.
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Symptom-based code when abnormal bleeding is the presenting problem leading to hysteroscopy.
`O34.2XX0`	Maternal care for uterine scar from previous surgery, no mention of complication, unspecified trimester	Relevant when prior uterine surgery exists and operative planning for hysteroscopic myomectomy must account for scar tissue (use appropriate obstetric codes if pregnant).
`N80.0`	Endometriosis of uterus (adenomyosis)	May coexist with fibroids and contribute to symptoms; documented for comprehensive management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76830`	Transvaginal ultrasound, limited or follow-up	Often used preoperatively to evaluate fibroid size/location and for postoperative assessment.
`58340`	Insertion of intrauterine device (IUD)	May be performed after myomectomy in the same setting or at follow-up for contraceptive management; not typically same-day if concurrent procedures increase risk.
`58210`	Dilation and curettage, diagnostic	May be performed diagnostically prior to operative hysteroscopy or concurrently if sampling of endometrium is indicated.
`58558`	Hysteroscopy, diagnostic, with sampling (endometrial biopsy)	Performed for evaluation of abnormal bleeding and may precede or accompany operative hysteroscopic procedures.
`51702`	Bladder catheterization, simple	Performed intraoperatively for urine output monitoring during anesthesia and surgical procedure.
`99024`	Postoperative follow-up visit global (by reporting provider)	Used to report postoperative follow-up visits during the global period when documentation supports separate reporting per payer rules.

OpenPayer