Summary & Overview
CPT 58950: Open Abdominal Debulking for Ovarian/Tubal/Peritoneal Malignancy
CPT code 58950 denotes an open abdominal debulking procedure for ovarian, tubal, or primary peritoneal malignancy that includes removal of the fallopian tubes, ovaries, and omentum. As a major gynecologic oncology operation, this code represents a high-complexity surgical service with significant implications for perioperative care, hospital resource use, and oncology care pathways nationwide. Coverage and payment for this procedure affect hospital surgical scheduling, oncology program capacity, and patient financial responsibility across major national payers. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the service, payer coverage patterns, common billing modifiers observed with major abdominal oncologic surgery, and benchmarking guidance for coding and claims submission. The publication also summarizes typical sites of service and operational considerations relevant to hospitals and surgical teams. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 58950 describes an open abdominal procedure for removal of an ovarian, tubal, or primary peritoneal malignancy with removal of the fallopian tubes, ovaries, and omentum. This is a major gynecologic oncology operative procedure involving resection of malignant tissue and bilateral salpingo-oophorectomy with omentectomy.
Service type: Major surgical oncology procedure
Typical site of service: Inpatient or outpatient hospital operating room with postoperative inpatient stay as clinically indicated.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old female presenting with an adnexal mass, pelvic pain, bloating, and suspicious imaging (ultrasound/CT) showing a complex ovarian lesion with omental caking. Preoperative evaluation includes history and physical, CA-125 tumor marker, cross-sectional imaging, and anesthesia assessment. The multidisciplinary gynecologic oncology team schedules an exploratory laparotomy with intent for maximal cytoreductive surgery. In the operating room under general anesthesia, the surgeon performs an abdominal approach, inspects the peritoneal cavity, removes the primary ovarian or tubal malignancy, performs bilateral salpingo-oophorectomy as indicated, and performs omentectomy. Intraoperative decisions may include additional procedures (peritoneal biopsies, lymph node assessment, bowel resection) based on disease spread. Postoperative workflow includes immediate recovery, inpatient monitoring for hemodynamic stability, pain control, VTE prophylaxis, pathology submission, staging determination, and coordination with medical oncology for adjuvant chemotherapy if indicated. Typical site of service is an inpatient acute care hospital or ambulatory surgical center when clinically appropriate; the service type is major surgical oncology (open abdominal gynecologic oncology procedure).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default reporting when no other modifier applies |