Summary & Overview
CPT 58954: Radical Abdominal Gynecologic Oncologic Resection
CPT code 58954 denotes a radical abdominal gynecologic oncologic resection that removes the uterus, cervix, ovaries, fallopian tubes, omentum, pelvic lymph nodes, and a limited number of para-aortic lymph nodes via an abdominal incision. This code captures a high-complexity, resource-intensive inpatient surgical service central to management of advanced gynecologic malignancies. Nationally, accurate use of this code affects hospital billing, case mix classification, and quality measurement for complex oncologic surgery.
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 the procedure, how the service is typically delivered, and what to expect in billing practice for high-complexity inpatient gynecologic oncology operations. The publication summarizes common modifiers in billing practice and highlights areas where coding precision matters for claims adjudication and reimbursement consistency.
The report provides benchmarks and policy-relevant notes on documentation expectations, inpatient setting considerations, and the interplay between surgical complexity and payer coverage determinations. Data not available in the input for specific contract terms, payer-specific rates, associated taxonomies, and ICD-10 diagnoses is stated where relevant.
Billing Code Overview
CPT code 58954 describes a radical abdominal procedure in which the provider removes the fallopian tubes, ovaries, omentum, the uterus and cervix, the pelvic lymph nodes, and a limited number of para-aortic lymph nodes through an abdominal incision. This procedure is an extensive gynecologic oncologic operation involving multi-organ resection and regional lymphadenectomy.
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Service type: Major abdominal gynecologic surgical oncology procedure
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Typical site of service: Hospital operating room with inpatient postoperative care
Clinical & Coding Specifications
Clinical Context
A typical patient is a postmenopausal woman or a premenopausal patient with gynecologic malignancy (for example, high-grade endometrial carcinoma or advanced ovarian carcinoma) who presents for an open abdominal radical hysterectomy with bilateral salpingo-oophorectomy, omentectomy, pelvic lymphadenectomy and limited para-aortic lymph node sampling. The workflow begins with preoperative evaluation in a gynecologic oncology clinic including staging imaging (CT/MRI), cancer-directed counseling, medical clearance, and consent. On the day of service the patient is admitted to the hospital surgical unit, receives general endotracheal anesthesia, and undergoes an exploratory laparotomy through a midline abdominal incision. The surgeon performs removal of the uterus and cervix, bilateral fallopian tubes and ovaries, the omentum, pelvic lymph node dissection, and limited para-aortic nodal sampling as indicated by intraoperative findings. Estimated blood loss, intraoperative frozen section when indicated, and specimen labeling for pathology are documented. Postoperatively the patient is transferred to the PACU and then to an inpatient gynecologic oncology floor for pain control, DVT prophylaxis, incision care, and initiation of adjuvant treatment planning based on final pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not typically appended; some payors use for standard reporting when no modifier applies |