Summary & Overview
CPT 58951: Cytoreductive Abdominal Surgery for Ovarian/Tubal/Peritoneal Malignancy
CPT code 58951 represents an extensive open abdominal cytoreductive surgery for ovarian, tubal, or primary peritoneal malignancy. The procedure combines bilateral salpingo-oophorectomy, hysterectomy, omentectomy, pelvic lymphadenectomy, and limited para-aortic lymph node dissection performed through an abdominal incision. This code is clinically significant due to its use in primary treatment of advanced gynecologic malignancies and its implications for hospital resource use, perioperative complexity, and postoperative care.
Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context of CPT code 58951, typical sites of service, and the kinds of benchmarks and policy considerations tied to high-complexity gynecologic oncology procedures. The publication covers coding and billing practice implications, common modifier usage patterns where applicable, and how payers approach coverage and medical necessity for extensive cytoreductive surgery. It also provides a concise clinical summary to support correct code selection and to inform revenue cycle and utilization review stakeholders.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and payer-specific fee benchmarks.
Billing Code Overview
CPT code 58951 describes a comprehensive abdominal surgical procedure for removal of an ovarian, tubal, or primary peritoneal malignancy. The procedure includes removal of the fallopian tubes and ovaries, removal of the omentum, hysterectomy (removal of the uterus and cervix), pelvic lymph node dissection, and limited para-aortic lymph node dissection, all performed through an abdominal incision.
Service Type: Extensive gynecologic oncologic abdominal surgery
Typical Site of Service: Inpatient hospital — operating room with post-anesthesia recovery and inpatient stay as required by oncologic surgery
Clinical & Coding Specifications
Clinical Context
A 58-year-old female presents with abdominal bloating, early satiety, pelvic pain, and an adnexal mass identified on pelvic ultrasound and CT scan. Tumor markers (CA-125) are elevated. Following multidisciplinary tumor board discussion, the patient is scheduled for an exploratory laparotomy with primary cytoreductive surgery for suspected epithelial ovarian carcinoma. The operative plan includes total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, bilateral pelvic lymph node dissection, and selective para-aortic lymph node sampling via an open abdominal incision. Preoperative workflow includes staging imaging, anesthesiology evaluation, informed consent discussing risks (bleeding, infection, organ injury), and placement of appropriate VTE prophylaxis. Intraoperative workflow includes midline laparotomy, assessment of disease burden, resection of uterus, cervix, bilateral ovaries and fallopian tubes, infracolic omentum removal, pelvic lymphadenectomy and limited para-aortic node sampling, hemostasis, and abdominal closure. Postoperative workflow includes monitoring in PACU, pain control, early ambulation, pathology submission for histologic diagnosis and staging, coordination of oncology follow-up for adjuvant therapy recommendations, and documentation of procedure details, nodal counts, estimated blood loss, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (No modifier) Standard reporting | Use when no modifier applies and reporting the primary procedure as performed |