Summary & Overview

CPT 58661: Laparoscopic Oophorectomy and Salpingectomy

CPT code 58661 denotes a laparoscopic procedure to remove one or both ovaries and one or both fallopian tubes, or a combination of these procedures. This code captures a commonly performed minimally invasive gynecologic operation used for benign and certain malignant indications, sterilization-related procedures when combined with adnexal removal, and risk-reduction surgeries. Nationally, accurate coding of laparoscopic adnexal surgery matters for quality measurement, resource allocation, and consistent reimbursement across surgical settings.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 58661, typical sites of service, and the scope of services represented by the code. The publication outlines what to expect in payer coverage and payment considerations at a national level, summarizes common billing and documentation themes relevant to laparoscopic adnexal removal, and notes where input data are not available.

This analysis is intended to inform billing and coding professionals, surgical administrators, and policy analysts about the clinical and administrative significance of CPT code 58661, including benchmarking context, common payer considerations, and areas where additional documentation supports appropriate code selection.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare58661CPTlaparoscopyoophorectomysalpingectomygynecologyambulatory surgeryoutpatient surgery

Billing Code Overview

CPT code 58661 describes a laparoscopic removal of one or both ovaries and fallopian tubes, or a combination of oophorectomy and salpingectomy performed using a laparoscope. The procedure involves removal of the adnexal structures via minimally invasive, laparoscopic techniques.

Service type: Minimally invasive gynecologic surgery (laparoscopic oophorectomy and/or salpingectomy)
Typical site of service: Hospital outpatient department or ambulatory surgery center (laparoscopic surgical setting)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 42-year-old woman with symptomatic bilateral ovarian cysts and a history of heavy menstrual bleeding presents for surgical management after failed medical therapy. Preoperative evaluation includes pelvic ultrasound confirming complex cystic adnexal masses suspicious for endometriomas, routine labs, and anesthesia assessment. The operative plan is a laparoscopic bilateral salpingo-oophorectomy (58661) to remove both ovaries and fallopian tubes using minimally invasive techniques. Intraoperative workflow includes general endotracheal anesthesia, laparoscopic entry (veress or open), inspection of the pelvis, lysis of adhesions as needed, isolation and division of the infundibulopelvic ligaments and utero-ovarian ligaments with energy devices or bipolar cautery, specimen retrieval in an endoscopic bag, hemostasis, and trocar site closure. Postoperative care includes PACU recovery, pain control, VTE prophylaxis, discharge instructions for wound care, activity limitations, and follow-up with the gynecologic surgeon. Indications for this procedure include benign adnexal masses, endometriosis refractory to medical therapy, prophylactic oophorectomy for high genetic risk, or nonfunctional painful ovaries. Potential intraoperative deviations such as conversion to open laparotomy, additional procedures (e.g., hysterectomy), or management of intraoperative complications will affect coding and may require appending appropriate modifiers.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced Services	Use when the laparoscopic procedure is partially reduced or incomplete compared to standard `58661`.
`53`	Discontinued Procedure	Use when the procedure is started but terminated before completion for patient safety reasons.
`57`	Data not available in the input.	Data not available in the input.
`22`	Increased Procedural Services	Use when the operative service requires substantially greater work than typical (e.g., extensive adhesiolysis).
`59`	Distinct Procedural Service	Use to indicate a separate laparoscopic procedure performed at a distinct site or session.
`62`	Two Surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the laparoscopic procedure.
`76`	Data not available in the input.	Data not available in the input.
`78`	Unplanned Return to the OR	Use when the patient returns to the operating room for a related procedure during the postoperative global period.
`79`	Unrelated Procedure or Service	Use when an unrelated procedure is performed during the postoperative period.
`50`	Bilateral Procedure	Use to indicate bilateral removal when documentation supports bilateral adnexectomy; some payors require modifiers or billing as bilateral units.
`LT`	Left Side	Use when coding laterality for left adnexectomy when payor requires laterality reporting.
`RT`	Right Side	Use when coding laterality for right adnexectomy when payor requires laterality reporting.
`62`	Two Surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the laparoscopic procedure.
`66`	Surgical Team (e.g., multiple specialists)	Use when a surgical team approach is documented (complex cases requiring team).

Taxonomy Code	Specialty	Notes
`208D00000X`	Obstetrics & Gynecology	General gynecologic surgeons commonly perform `58661`.
`207V00000X`	General Surgery	General surgeons with advanced laparoscopic skills may perform adnexal procedures in some settings.
`208U00000X`	Gynecologic Oncology	Gynecologic oncologists perform complex adnexal resections and staging when malignancy is suspected.
`363A00000X`	Reproductive Endocrinology/Infertility	REI specialists may perform adnexal surgery when fertility-preserving considerations apply.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N83.2`	Ovarian cyst, rupture of	Indication for adnexal surgery when hemorrhage or persistent symptomatic cyst occurs.
`N83.20`	Ovarian cyst, unspecified	Common benign indication for adnexal removal when symptomatic or suspicious.
`N80.1`	Endometriosis of ovary	Endometriomas often necessitate salpingo-oophorectomy when medical therapy fails.
`D27`	Benign neoplasm of ovary	Ovarian neoplasm management may include laparoscopic removal of ovary/ adnexa.
`Z15.01`	Genetic susceptibility to malignant neoplasm of breast-ovarian (BRCA1)	Prophylactic bilateral salpingo-oophorectomy is performed for high genetic risk.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58661`	Laparoscopy, surgical, with removal of both ovaries and/or fallopian tubes, unilateral or bilateral	Primary code for laparoscopic salpingo-oophorectomy; used when one or both adnexa are removed laparoscopically.
`58662`	Laparoscopy, surgical; with removal of adnexal structures with vaginal hysterectomy (laparoscopic assisted vaginal hysterectomy)	Use when a vaginal hysterectomy is performed in combination with adnexal removal in the same operative episode.
`58999`	Unlisted procedure, reproductive system, laparoscopic	Use for laparoscopic reproductive procedures not described by existing codes, e.g., novel adjunctive techniques.
`58558`	Hysteroscopy, surgical; for removal of retained products, polypectomy, or other intrauterine procedures	Frequently performed pre- or postoperatively for uterine indications when combined with adnexal surgery in same session.
`58670`	Laparoscopy, surgical; with removal of pelvic adnexal mass and/or cyst	Use when the indication is removal of adnexal mass distinct from standard salpingo-oophorectomy coding; may be reported when mass excision is primary.