Summary & Overview
CPT 58952: Radical Debulking for Ovarian, Tubal, or Peritoneal Malignancy
CPT code 58952 denotes an open abdominal radical surgery to remove ovarian, tubal, or primary peritoneal malignancy, including removal of the fallopian tubes, ovaries, omentum, and radical excision of intraabdominal or peritoneal tumor masses. This code captures complex gynecologic oncology procedures that are resource-intensive and central to cancer care pathways. Nationally, accurate use of this code affects inpatient surgical reporting, hospital reimbursement, and care quality measurement for advanced ovarian and peritoneal cancers.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes coverage patterns, authorization practices, and common coding considerations encountered across these major commercial insurers and the Medicare program.
Readers will find a concise clinical context for the procedure, benchmarks for utilization and site-of-service expectations, and operational guidance on how this code is presented in claims (service type and typical site of service). The report highlights coding specificity for radical debulking with omentectomy, common modifier usage (listed separately), and areas where documentation drives appropriate code selection. Data not available in the input is noted where relevant. The summary is intended for coding professionals, revenue cycle leaders, and clinical teams involved in gynecologic oncology care.
Billing Code Overview
CPT code 58952 describes a surgical procedure for removal of an ovarian, tubal, or primary peritoneal malignancy by performing salpingo-oophorectomy with omentectomy and radical excision of intraabdominal or peritoneal tumor masses through an abdominal incision. This is an open abdominal oncologic procedure that addresses malignancies of the ovary, fallopian tube, or primary peritoneum.
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Service type: Major open gynecologic oncology surgery (abdominal radical debulking with omentectomy)
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Typical site of service: Inpatient hospital surgical setting (abdominal operative suite with postoperative inpatient care)
Clinical & Coding Specifications
Clinical Context
A 58-year-old female presents with progressive abdominal distension, pelvic pain, and an adnexal mass on imaging. Cross-sectional imaging (CT/MRI) demonstrates bilateral ovarian masses with omental caking and suspected peritoneal implants consistent with advanced epithelial ovarian carcinoma. Tumor markers (CA-125) are elevated. After multidisciplinary review, the patient is scheduled for an open exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy, infracolic omentectomy, and radical tumor debulking via a midline abdominal incision. The intraoperative workflow includes general anesthesia, diagnostic survey of the abdomen, peritoneal washings, systematic resection of visible tumor from diaphragmatic peritoneum, pelvic and para-aortic lymph node assessment as indicated, omentectomy, bilateral salpingo-oophorectomy, and achievement of cytoreduction to no gross residual disease when possible. Postoperative care includes monitoring in PACU, pain control, DVT prophylaxis, early ambulation, and coordination of adjuvant chemotherapy with medical oncology based on final pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default reporting | Use when no specific modifier applies to the service. |
11 |