Summary & Overview
CPT 58615: Tubal Occlusion with Device, Vaginal or Suprapubic Approach
CPT code 58615 represents surgical tubal occlusion performed with a device via either a vaginal or suprapubic approach. This code captures a commonly used sterilization technique and is relevant to reproductive health services nationally due to its role in permanent contraception and implications for surgical routing, site-of-service decisions, and payer coverage policies. The code is generally billed for outpatient surgical settings but can occur in hospital operating rooms depending on approach and patient factors.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find operational benchmarks and clinical context for use of 58615, including typical sites of service and procedure descriptions. The publication also outlines common billing considerations and the policy landscape affecting authorization and setting decisions. Content is presented to help billing managers, policy analysts, and clinical administrators understand where 58615 fits in procedural coding, what to expect in payer interactions, and which clinical scenarios typically generate use of the code.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific reimbursement benchmarks.
Billing Code Overview
CPT code 58615 describes a surgical procedure in which the provider uses a device to occlude one or both fallopian tubes. The procedure is performed either via a vaginal approach (incision through the vaginal wall) or a suprapubic approach (incision just above the pubic bone).
-
Service type: Surgical tubal occlusion using a device
-
Typical site of service: Hospital operating room or ambulatory surgery center when performed via a suprapubic incision; outpatient surgical suite or office-based procedure room when performed via a vaginal approach
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 32–40-year-old woman electing permanent contraception after completing childbearing. She presents to the outpatient ambulatory surgery center or hospital's same-day surgery unit for a bilateral tubal occlusion. Preoperative evaluation includes informed consent, pregnancy test, and review of prior abdominal or pelvic surgeries. The procedure is performed under regional or general anesthesia with a suprapubic (mini-laparotomy) or vaginal approach and involves placing a device to occlude one or both fallopian tubes. Intraoperative workflow includes time-out, antiseptic preparation, incision (vaginal wall or suprapubic), identification of the tubes, placement of the occlusive device, hemostasis, and layered wound closure. Postoperative care includes recovery room monitoring, discharge instructions for wound care and activity restrictions, and follow-up in clinic to assess healing and counsel on efficacy and complications. Typical sites of service are the ambulatory surgery center, hospital outpatient department, or same-day inpatient surgical unit depending on patient comorbidities and anesthesia needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | When no special circumstances apply and the full, typical service was rendered. |
11 | Principal physician of record | When the reporting physician is the primary surgeon responsible for the procedure. |
22 | Unusual procedural service | For substantially greater work than typical, documented in operative note (rare for routine tubal occlusion). |
23 | Unusual anesthesia — medically necessary | When general anesthesia is required for medically necessary reasons in the absence of a nerve block. |
26 | Professional component | Use when separating professional from technical components if facility bills technical component separately (rare for this surgical code). |
50 | Bilateral procedure | When both fallopian tubes are treated and payer requires bilateral modifier reporting instead of bilateral CPT modifier rules. |
52 | Reduced services | If the procedure is started but not completed as planned and service is reduced, with documentation. |
53 | Discontinued procedure | When procedure is terminated due to extenuating circumstances or patient safety concerns before completion. |
62 | Two surgeons — co-surgery | When two surgeons of different specialties perform distinct portions of the procedure concurrently and documentation supports co-surgery. |
63 | Procedure performed on infants less than 4 kg | Not commonly used for this adult procedure; included for completeness when applicable to neonates. |
66 | Surgical team approach | When a documented team approach is used for complex cases (rare for routine sterilization). |
78 | Unplanned return to OR following initial procedure | When the patient returns to the operating room for a related reason during the global period. |
80 | Assistant surgeon | When a qualified assistant surgeon performs part of the procedure and payer requires reporting. |
TC | Technical component | When the facility bills only the technical component and the professional component is billed separately. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207V00000X | Obstetrics & Gynecology | Most common specialty performing tubal occlusion and sterilization procedures. |
2080P0005X | General Surgery | General surgeons may perform suprapubic approaches in select settings. |
207VP0000X | Gynecologic Oncology | May perform tubal occlusion when concurrently managing oncologic procedures. |
208000000X | Family Medicine | Some family physicians with surgical privileges perform outpatient sterilization in select practices. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
Z30.2 | Encounter for sterilization | Primary diagnosis code for a patient undergoing elective tubal occlusion. |
Z30.9 | Encounter for contraceptive management, unspecified | Used when contraceptive management discussion leads to sterilization decision but exact reason unspecified. |
Z31.5 | Encounter for procreative management; counseling for sterilization | Counseling visits preceding the procedure and documented reasons for sterilization. |
N97.9 | Female infertility, unspecified | Occasionally present in the history when sterilization is considered after completed childbearing despite prior fertility issues. |
Z98.890 | Other specified postprocedural states | Used in history when documenting prior pelvic procedures that may affect surgical approach (adhesions, prior tubal surgery). |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
58611 | Ligation or transection of fallopian tube(s), abdominal or vaginal approach (separate procedure) | Alternative sterilization technique; may be performed instead of device occlusion when ligation/transection is chosen. |
58670 | Laparoscopy, surgical; with fulguration of oviducts, any method | Minimally invasive alternative for tubal occlusion often performed laparoscopically rather than via vaginal or suprapubic incision. |
58340 | Insertion of intrauterine device (IUD) | Non-permanent contraceptive option that may be discussed or inserted prior to discharge in counseling workflow. |
59400 | Routine obstetric care including antepartum, delivery, and postpartum care | May be relevant when tubal occlusion is performed postpartum at time of cesarean delivery (though code 58615 describes non-cesarean approaches). |
99024 | Postoperative follow-up visit, included in global period (for reporting if separate) | Used for documented postoperative evaluation when payer requires separate reporting beyond the global surgical package. |