Summary & Overview
CPT 58573: Laparoscopic Hysterectomy for Enlarged Uterus
CPT code 58573 denotes a laparoscopic hysterectomy performed for an enlarged uterus—typically due to fibroids—where the uterus, cervix, and fallopian tubes or ovaries are removed through trocar ports or via the vaginal canal, and the uterus usually weighs more than 250 g. This code captures a common gynecologic procedure that has implications for surgical planning, site-of-service decisions, and national utilization monitoring because enlarged uteri often require different operative techniques and resource use than standard hysterectomy.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, common billing modifiers and related administrative considerations, and what to expect from payer coverage policies and reimbursement frameworks. The publication highlights benchmarks and coding practice considerations relevant to outpatient surgical centers and hospital outpatient departments, and it outlines policy updates and billing nuances that affect claim submission and audit risk. Data not available in the input for payor-specific rates, ICD-10 pairings, and associated taxonomies are noted where applicable.
Billing Code Overview
CPT code 58573 describes a laparoscopic hysterectomy for an enlarged uterus (usually due to fibroids) in which the provider incises all uterine, ovarian, and cervical attachments and removes the uterus, cervix, and fallopian tubes or ovaries (or both) through trocar ports or via the vaginal canal. The description specifies the uterus is larger than normal, typically weighing more than 250 g.
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Service type: Minimally invasive gynecologic surgery (laparoscopic hysterectomy for enlarged uterus)
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Typical site of service: Hospital outpatient department or ambulatory surgery center, with potential intraoperative vaginal extraction as described.
Clinical & Coding Specifications
Clinical Context
A 46-year-old woman with symptomatic uterine fibroids presents for definitive surgical management after failed medical therapy and persistent heavy, painful menstrual bleeding and pelvic pressure. Imaging (transvaginal ultrasound or MRI) documents an enlarged, fibroid-laden uterus estimated to weigh >250 g. The patient has completed childbearing and prefers definitive treatment. Preoperative evaluation includes history and physical, labs (CBC, type and screen), anesthesia assessment, and informed consent discussing laparoscopic approach, potential need for vaginal extraction or morcellation alternatives, and risks including bleeding, infection, organ injury, and conversion to open surgery.
On the day of surgery the patient undergoes general anesthesia. The surgical team establishes pneumoperitoneum and places laparoscopic ports. The surgeon transects the uterine vascular pedicles and all attachments to the uterus, cervix, and adnexa as indicated, removes the uterus, cervix, and one or both fallopian tubes and/or ovaries through trocar ports or via the vaginal canal, and controls hemostasis. Specimens are extracted intact through the vagina when feasible or via contained tissue extraction through trocar sites per institutional practice. Postoperative workflow includes PACU recovery, pain control, discharge planning (same-day or overnight), and pathology submission of the surgical specimen.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |