Summary & Overview
CPT 58925: Open Ovarian Cystectomy via Abdominal Incision
CPT code 58925 denotes an open ovarian cystectomy performed through an abdominal incision to remove a cyst from one or both ovaries. It is a common gynecologic surgical procedure when cysts are large, symptomatic, or not amenable to minimally invasive management. Nationally, this code is relevant for hospital and ambulatory surgery billing for gynecologic surgery, affecting surgical scheduling, coding compliance, and facility resource use.
This analysis covers key payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and the typical sites of service, plus benchmarks commonly reviewed for this service line. The publication summarizes standard billing context for CPT code 58925, highlights payer coverage considerations, and outlines where to find policy updates affecting authorization and facility billing.
The content is organized to help coding professionals, billing managers, and policy analysts quickly understand the clinical procedure tied to 58925, compare how major payers approach coverage and claims processing, and identify practice-level implications for facility and surgical revenue cycle management. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 58925 describes the surgical removal of a cyst from one or both ovaries through an abdominal incision. This represents an open ovarian cystectomy performed via laparotomy rather than a minimally invasive approach.
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Service type: Surgical procedure — open ovarian cyst removal
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Typical site of service: Inpatient or outpatient hospital operating room, or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 34-year-old female presents with progressive unilateral lower abdominal pain and an adnexal mass identified on pelvic ultrasound consistent with an ovarian cyst measuring 6.5 cm. Conservative management with observation and hormonal suppression was attempted but pain persisted and cyst size remained unchanged on interval imaging. After preoperative evaluation, counseling, and informed consent, the patient is scheduled for an open ovarian cystectomy via an abdominal incision because of prior extensive intra-abdominal adhesions and concern for malignancy based on imaging characteristics.
The clinical workflow includes preoperative history and physical, anesthesia evaluation, informed consent, preoperative labs and pregnancy test, and surgical scheduling. In the operating room under general anesthesia, a lower midline or Pfannenstiel incision is made, the ovary is delivered into the field, the cyst is carefully dissected and removed with ovarian tissue preservation when feasible, hemostasis is achieved, and the abdomen is closed in layers. Postoperative recovery includes monitoring in PACU, pain control, early ambulation, wound care instructions, and a postoperative clinic visit for pathology review and recovery assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to perform the procedure is substantially greater than typical (e.g., extensive adhesiolysis). |