Summary & Overview
CPT 58770: Tubal Recanalization via Abdominal Incision
CPT code 58770 represents an abdominal surgical procedure to create a new opening at the distal fallopian tube to allow ova to pass from the ovary into the uterus. This fertility-restoring surgery is performed via an abdominal incision and is relevant to reproductive and gynecologic surgical practices nationwide. The code is used for billing and policy purposes across a range of commercial and public payers.
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 for tubal recanalization, the typical site of service and service type, and the common payer landscape for this procedure nationally. The publication outlines typical billing considerations, common modifiers (listed separately), and where to locate related policy guidance. It also provides benchmarks and policy updates where available and notes when specific data elements are not provided. Clinical context includes indications for restoring tubal patency and the abdominal surgical approach described by the code. This summary is intended for revenue cycle leaders, clinicians involved in gynecologic surgery, and policy analysts seeking a clear, national-level reference for CPT code 58770.
Billing Code Overview
CPT code 58770 describes a surgical procedure in which the provider creates a new opening at the end of a fallopian tube so that eggs from the ovary can pass into the uterus. The procedure is performed via an abdominal incision.
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Service type: Surgical reproductive tract procedure (tubal surgery for patency restoration)
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Typical site of service: Hospital operating room or ambulatory surgery center via an abdominal approach
Clinical & Coding Specifications
Clinical Context
A typical patient is a 32-year-old woman presenting with infertility and a history of proximal tubal occlusion diagnosed on hysterosalpingography. After evaluation by a reproductive endocrinologist and counseling, the patient is scheduled for an open surgical procedure to create a new opening at the distal end of the fallopian tube (neosalpingostomy) via an abdominal incision. The clinical workflow includes preoperative evaluation (history, physical, pregnancy test, informed consent), perioperative anesthesia assessment, abdominal entry via a mini-laparotomy or Pfannenstiel incision, identification of the obstructed distal tube, excision of scarred fimbrial tissue, spatulation of the tubal end, and creation of a patent ostium with microsurgical technique. Intraoperative procedures often include tubal patency testing (chromopertubation), possible adhesiolysis, and hemostasis. Postoperative recovery includes monitoring in a PACU, pain control, discharge instructions regarding activity limitations, and outpatient follow-up with instructions for timing of attempts at conception. Typical site of service is an inpatient or outpatient hospital surgical suite or ambulatory surgery center, and the service type is open abdominal gynecologic surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds usual for 58770 due to extensive adhesiolysis or unexpected findings. |