Summary & Overview
CPT 59120: Adnexal Excision for Ectopic Pregnancy
CPT code 59120 denotes surgical removal of a fallopian tube, an ovary, or both to treat an ectopic pregnancy. This code captures definitive adnexal excision when an ectopic gestation is embedded in adnexal tissues or when rupture and hemorrhage necessitate removal. Nationally, management of ectopic pregnancy with surgical excision remains an important component of gynecologic emergency care and surgical gynecology practice patterns.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise policy- and billing-focused overview to help clinical and revenue cycle teams understand coding context and payor coverage patterns.
Readers will find: a clear description of clinical indications and service setting; an outline of common billing modifiers and considerations (data provided separately); and a summary of payer coverage landscape and typical site-of-service implications. The content is organized to support clinicians, coders, and administrators who need a reliable reference for documentation, billing pathways, and operational planning related to surgical management of ectopic pregnancy.
Billing Code Overview
CPT code 59120 describes a surgical procedure in which the provider removes the fallopian tube, the ovary, or both to treat an ectopic pregnancy. The procedure is performed when an ectopic pregnancy is located in or around the fallopian tube or ovary, when a large ectopic fetal mass is embedded in adnexal structures, or when the fallopian tube has ruptured and removal is required to control hemorrhage and manage the ectopic pregnancy.
Service Type: Surgical procedure (adnexal excision for ectopic pregnancy)
Typical Site of Service: Operating room in an inpatient or outpatient surgical setting (abdominal or vaginal approach may be used, per clinical indication).
Clinical & Coding Specifications
Clinical Context
A 29-year-old woman presents to the emergency department with acute lower abdominal pain, vaginal bleeding, and lightheadedness. Transvaginal ultrasound demonstrates an adnexal mass with no intrauterine pregnancy and a positive beta-hCG consistent with a tubal ectopic pregnancy. Vital signs show tachycardia and borderline hypotension concerning for rupture. The obstetrics/gynecology surgical team evaluates the patient, obtains informed consent for operative management, and proceeds to the operating room for an urgent abdominal procedure. Intraoperatively, the right fallopian tube is found to be ruptured with active bleeding and devitalized tissue surrounding the ectopic gestation. The surgeon performs a unilateral salpingectomy with removal of the ectopic pregnancy. The specimen is sent to pathology; the patient is recovered in the PACU and admitted for observation with postoperative pain control, intravenous fluids, and serial hemoglobin checks.
Service Type: Surgical management of ectopic pregnancy (salpingectomy/salpingo-oophorectomy).
Typical Site of Service: Hospital operating room (emergency or scheduled inpatient OR); may also occur in ambulatory surgery center for stable, unruptured cases.
Typical Clinical Workflow: ED or clinic evaluation → imaging and labs → surgical consultation → preoperative assessment and consent → operative procedure (laparoscopic or open salpingectomy/salpingo-oophorectomy) → postoperative recovery, monitoring, pathology processing, and inpatient or outpatient follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for 59120 (e.g., extensive adhesiolysis, hemorrhage control). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned (e.g., attempt aborted due to patient instability). |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after anesthesia has begun. |
59 | Distinct procedural service | Use to indicate a separate, distinct procedure unrelated to the primary 59120 performed the same day. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons for shared responsibility (co-surgeons). |
76 | Repeat procedure by same physician | Data not provided in raw modifiers list; not listed. |
78 | Unplanned return to the operating room for related procedure following initial procedure on the same day or during the postoperative period | Use when the patient requires a return to OR for hemorrhage or complication after 59120. |
50 | Bilateral procedure | Use when bilateral adnexal removal is performed (bilateral salpingectomy/salpingo-oophorectomy). |
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of the procedure | Use when a separate E/M visit is performed and documented on the day of 59120 (e.g., preoperative assessment with significant decision making). |
26 | Professional component | Rarely used for surgical procedure codes; include only if billing professional component separate from technical (typically not applicable to 59120). |
LT | Left side | Use to indicate procedure performed on the left adnexa when side-specific reporting is required by payer. |
RT | Right side | Use to indicate procedure performed on the right adnexa when side-specific reporting is required by payer. |
51 | Multiple procedures | Use when additional unrelated CPT surgical procedures are performed the same operative session in addition to 59120. |
52 | Reduced services | Duplicate of 52 above; included once only. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Obstetrics & Gynecology | Primary specialty performing salpingectomy/salpingo-oophorectomy for ectopic pregnancy. |
| 207VP0002X | Gynecologic Surgery | Subspecialty focus on complex pelvic surgery and adnexal procedures. |
| 208600000X | General Surgery | May perform abdominal approaches in certain hospitals or trauma/acute settings. |
| 364S00000X | Acute Care Surgery | May be involved for emergent open procedures when OB/GYN unavailable. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O00.1 | Tubal pregnancy | Primary indication for 59120 when removal of the fallopian tube is required for ectopic pregnancy. |
O00.8 | Other ectopic pregnancy | Includes ovarian or abdominal ectopic pregnancies requiring adnexal removal. |
O00.9 | Ectopic pregnancy, unspecified | Used when specific location not documented but ectopic pregnancy is treated surgically. |
O03.9 | Spontaneous abortion, incomplete or unspecified | May be relevant if differential diagnosis or concurrent uterine evacuation is performed. |
R10.9 | Unspecified abdominal pain | Common presenting symptom prompting evaluation that leads to diagnosis of ectopic pregnancy. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
59120 | Salpingectomy or oophorectomy for ectopic pregnancy — removal of fallopian tube or ovary, abdominally or vaginally | Primary procedure for management of tubal or ovarian ectopic pregnancy. |
44970 | Exploratory laparotomy, peritoneal cavity; drainage of peritoneal abscess and/or removal of nonobstructing adnexal pathology (open approach) | May be used for open abdominal management in unstable or ruptured ectopic when laparotomy is required. |
58661 | Laparoscopy, surgical, with removal of adnexal structures (salpingectomy or oophorectomy) | Laparoscopic approach frequently used for 59120 when minimally invasive surgery is performed. |
58662 | Laparoscopy, surgical; with lysis of adhesions (salpingostomy or other) | Used if significant adhesiolysis is performed at time of adnexal surgery for ectopic pregnancy. |
49000 | Unlisted laparoscopy procedure, abdominal, peritoneal cavity | Used when a laparoscopic procedure does not have an exact code match for complex combined procedures performed with 59120. |