Summary & Overview
CPT 58760: Fimbrioplasty, Removal of Distal Tubal Adhesions
CPT code 58760 represents fimbrioplasty — an operative gynecologic procedure to remove adhesions at the fimbrial end of the fallopian tube via an abdominal incision to restore patency and permit oocyte transport. Nationally, this code is relevant to reproductive surgery, fertility-related care pathways, and inpatient/outpatient surgical billing practices. It is most commonly billed by gynecologic surgeons and centers performing tubal surgery.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of code definition and clinical context, typical sites of service, and which payers commonly cover or adjudicate this service. The publication presents benchmarks for utilization and allowed amounts where available, notes common billing considerations, and summarizes relevant policy and coding guidance affecting claims processing for tubal reconstructive procedures.
The report is organized to serve payers, revenue cycle professionals, and clinicians: it starts with clinical and coding fundamentals, follows with payer coverage patterns and benchmark data, and closes with operational notes on claim lines and documentation expectations. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
CPT code 58760 describes a fimbrioplasty: a surgical procedure in which the provider removes adhesions around the fimbrial end of the fallopian tube to reopen the tube and allow passage of oocytes from the ovary to the uterus. The procedure is performed via an abdominal incision and involves operative correction of distal tubal occlusion.
Service type: Surgical procedure — gynecologic/operative tubal surgery
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center, accessed through an abdominal incision.
Clinical & Coding Specifications
Clinical Context
A typical patient is a reproductive‑aged woman presenting with suspected tubal factor infertility, recurrent ectopic pregnancy, or chronic pelvic pain after prior pelvic infection or surgery. She has completed baseline fertility evaluation including hysterosalpingography or sonohysterography showing distal tubal occlusion or fimbrial adhesions. After informed consent and preoperative clearance, the patient is brought to the operating room for an abdominal approach fimbrioplasty via a small lower abdominal incision under general anesthesia. The surgical team performs adhesion lysis and reconstruction of the fimbrial end to restore patency; intraoperative chromotubation (dye test) may be performed to confirm tubal patency. Typical workflow includes preoperative anesthesia assessment, prophylactic antibiotics per facility protocol, abdominal incision and exposure, microsurgical lysis of fimbrial adhesions, confirmation of patency, hemostasis, and layered closure. Postoperative recovery includes monitoring for bleeding, infection, and anesthesia complications, with discharge instructions addressing activity restrictions and follow‑up for fertility planning or further assisted reproductive options.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Not a standard HCPCS modifier; reserved) | Data not applicable for clinical use; do not append routinely. |