Summary & Overview
CPT 58580: Transcervical Radiofrequency Ablation of Uterine Fibroids
CPT code 58580 represents transcervical radiofrequency ablation of uterine fibroids performed under ultrasound guidance. This minimally invasive gynecologic procedure offers an organ-preserving alternative to hysterectomy and uterine-sparing interventions, with implications for outpatient procedural care, device utilization, and reimbursement pathways nationwide. Key national payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of what the code covers clinically, the typical sites of service, and the payer landscape. The publication outlines benchmark considerations for coverage and billing, highlights policy and coding updates relevant to adoption and reimbursement, and provides clinical context about indications and procedural settings. It also summarizes common modifiers and operational implications for facilities and clinicians. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 58580 describes a minimally invasive procedure in which the provider inserts a radiofrequency probe through the cervix to ablate one or more uterine fibroids under ultrasound guidance and monitoring. This service is a targeted, image-guided fibroid ablation performed transcervically.
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Service type: Image-guided, transcervical radiofrequency ablation of uterine fibroids
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Typical site of service: Hospital outpatient department or ambulatory surgery center (procedural suite) where ultrasound guidance and procedural monitoring are available.
Clinical & Coding Specifications
Clinical Context
A 42-year-old woman with symptomatic intramural and subserosal uterine fibroids presents with heavy menstrual bleeding, pelvic pressure, and desire to avoid hysterectomy. Following evaluation with pelvic ultrasound and MRI confirming one or more accessible fibroids, the gynecologist schedules a uterine fibroid radiofrequency ablation procedure. Under conscious sedation or monitored anesthesia care in an ambulatory surgery center or hospital outpatient setting, the provider inserts a transcervical radiofrequency probe into the uterine cavity and advances it into target fibroids under real-time transvaginal ultrasound guidance. The procedure includes intraoperative imaging to confirm probe placement, delivery of radiofrequency energy to thermally ablate fibroid tissue, and monitoring for hemostasis. Typical workflow steps: preoperative evaluation and informed consent, anesthesia administration, ultrasound localization, transcervical probe insertion and ablation, postoperative recovery and discharge with instructions, and follow-up imaging or clinical assessment to document symptom improvement and fibroid volume reduction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the procedure requires substantially greater effort or complexity than typical (document justification). |
23 | Unusual anesthesia | Use when medically necessary anesthesia is provided for a procedure usually performed with local or no anesthesia. |
50 | Bilateral procedure | Generally not applicable because this procedure targets uterine fibroids (organ-based) rather than bilateral anatomic sites; rarely used. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is started but stopped due to extenuating circumstances or patient safety concerns. |
59 | Distinct procedural service | Use when another unrelated procedure is performed on the same day that is not usually bundled. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons during the procedure. |
63 | Procedure performed on infants less than 4 kg | Rarely applicable; included for completeness if performed on neonates (not typical). |
66 | Surgical team | Use when a surgical team (multiple providers) performs the procedure. |
76 | Repeat procedure by same physician | Use if the same physician repeats the procedure within the global period. |
77 | Repeat procedure by another physician | Use if a different physician repeats the procedure within the global period. |
78 | Unplanned return to the operating/procedure room for a related procedure during the postoperative period | Use for reoperation for complications related to the initial procedure. |
79 | Unrelated procedure or service during the postoperative period | Use when an unrelated procedure is performed during the global period. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Obstetrics & Gynecology | Most common specialty performing transcervical radiofrequency ablation of fibroids. |
| 207VP0800X | Gynecologic Oncology (subspecialty of OB/GYN) | May be involved for complex uterine pathology or large fibroids requiring oncologic expertise. |
| 363L00000X | Radiology | Interventional or ultrasound-guided imaging support for localization and monitoring during the procedure. |
| 2087S0122X | Female Pelvic Medicine & Reconstructive Surgery | Specialists who manage complex pelvic floor and uterine preservation cases. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D25.0 | Submucous leiomyoma of uterus | Submucosal fibroids that distort the uterine cavity and produce heavy bleeding; may be targeted if accessible transcervically. |
D25.1 | Intramural leiomyoma of uterus | Common location for symptomatic fibroids amenable to radiofrequency ablation depending on size and location. |
D25.2 | Subserosal leiomyoma of uterus | Fibroids projecting to the serosal surface that can cause bulk symptoms; may be treated if accessible. |
D25.9 | Leiomyoma of uterus, unspecified | Used when fibroid type is documented but not specified; captures general indication for ablation. |
N93.9 | Abnormal uterine and vaginal bleeding, unspecified | Symptom-driven diagnosis supporting intervention when bleeding is a primary complaint. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
76830 | Transvaginal ultrasound, real-time with image documentation, fetal and maternal evaluation when performed (can include guidance) | Used for intraoperative guidance and localization of fibroids during transcervical radiofrequency ablation. |
99213 | Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes | Common preoperative or postoperative E/M visit to evaluate symptoms and review results. |
01990 | Anesthesia for procedures on the uterus when patient is not in labor (general or regional) | Used if monitored anesthesia care, regional, or general anesthesia is reported separately and applicable. |
58558 | Hysteroscopy, diagnostic, with sampling (endometrial) when performed | May be performed preoperatively or intraoperatively to assess the uterine cavity prior to ablation. |
58300 | Insertion of intrauterine device (IUD) | Occasionally performed in the same episode of care for concurrent management of bleeding (separate service). |