CPT 59130 Abdominal Ectopic Removal Reimbursement | OpenPayer

Summary & Overview

CPT 59130: Abdominal Removal of Ectopic Pregnancy

CPT code 59130 represents the open surgical removal of an ectopic pregnancy located in the abdominal cavity via an abdominal incision. This code captures a high-acuity gynecologic procedure that is clinically significant because abdominal ectopic pregnancies carry elevated risk and often require definitive surgical management. Nationally, accurate coding of this procedure matters for quality measurement, claims administration, and tracking of emergent gynecologic surgical care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for CPT code 59130, common service settings, and the typical procedure profile. The publication outlines benchmarks and coding considerations, summarizes relevant policy updates that affect coverage and claims processing, and provides a practical reference for coding and billing teams. Where available, the report highlights utilization patterns and payment benchmarks to support revenue cycle and compliance workflows.

Data not available in the input for payor-specific fee schedules, associated taxonomies, and ICD-10 diagnosis mappings.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareCPT 59130ectopic pregnancyabdominal surgerygynecologic surgeryoperative codingsurgical billinghospital servicesambulatory surgery centerprocedure coding

Billing Code Overview

CPT code 59130 describes the surgical removal of an ectopic pregnancy located within the abdominal cavity via an abdominal incision. This procedure involves a laparotomy or other open abdominal approach to locate and excise the ectopic gestation when it is not amenable to less invasive techniques.

Service Type: Surgical – Abdominal ectopic pregnancy removal

Typical Site of Service: Hospital operating room or ambulatory surgical center using an operating room setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

Clinical & Coding Specifications

Clinical Context

A patient, typically a woman of reproductive age, presents to the emergency department with acute lower abdominal pain, vaginal bleeding, and signs of hemodynamic instability (tachycardia, hypotension) or localized peritoneal irritation. Transvaginal ultrasound and serial quantitative beta-hCG testing identify an extrauterine gestation located within the abdominal cavity (primary abdominal ectopic pregnancy) or an ectopic pregnancy not amenable to minimally invasive removal. The surgical team prepares for an open abdominal approach under general anesthesia. A midline or Pfannenstiel abdominal incision is made, the abdominal cavity is explored, the ectopic gestation is identified and removed, bleeding is controlled, and the abdomen is irrigated and closed. Typical perioperative workflow includes preoperative consent, crossmatch and blood availability if needed, intraoperative specimen handling, postoperative monitoring in PACU or ICU if unstable, and discharge planning with follow-up beta-hCG monitoring and contraception counseling as appropriate. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical difficulty substantially exceeds typical for the procedure.

CPT 59151: Laparoscopic Adnexal Removal for Ectopic Pregnancy

CPT-59150-LAPAROSCOPIC-CONSERVATIVE-ECTOPIC-PREGNANCY-MANAGEMENT

CPT 59150: Laparoscopic Conservative Management of Ectopic Pregnancy

CPT-59100-EARLY-GESTATION-ABDOMINAL-CESAREAN-VARIANT

CPT 59100: Early-Gestation Abdominal Cesarean-Type Procedure

CPT-59160-POSTPARTUM-ENDOMETRIAL-CURETTAGE-VAGINAL-APPROACH

CPT 59160: Postpartum Endometrial Curettage, Vaginal Approach

CPT-59140-CERVICAL-ECTOPIC-PREGNANCY-REMOVAL-VAGINAL-APPROACH

CPT 59140: Removal of Cervical Ectopic Pregnancy, Vaginal Approach

CPT-59136-INTERSTITIAL-ECTOPIC-PREGNANCY-RESECTION-ABDOMINAL-APPROACH

CPT 59136: Interstitial Ectopic Pregnancy Resection, Abdominal Approach

CPT-59120-ADNEXAL-EXCISION-ECTOPIC-PREGNANCY

CPT 59120: Adnexal Excision for Ectopic Pregnancy

CPT-59121-TUBAL-OVARIAN-INCISION-ECTOPIC-PREGNANCY-REMOVAL

CPT 59121: Tubal or Ovarian Incision to Remove Small Ectopic Pregnancy

23

Taxonomy Code	Specialty	Notes
207V00000X	General Surgery	General surgeons may perform open abdominal procedures and manage intra-abdominal hemorrhage.
207Q00000X	Obstetrics & Gynecology	Gynecologic surgeons most commonly perform ectopic pregnancy removal procedures.
2080P0002X	Emergency Medicine	Emergency physicians are often involved in initial stabilization and decision-making for surgical intervention.
208000000X	Family Medicine	Family physicians with surgical training in some settings may participate in care or stabilization.
208800000X	Hospitalist/Internal Medicine	Hospitalists manage perioperative medical optimization and inpatient postoperative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O00.1`	Tubal pregnancy	Common ectopic pregnancy location; differentiates tubal from abdominal ectopic diagnoses.
`O00.8`	Other ectopic pregnancy	Includes abdominal ectopic pregnancies when a more specific code is not available.
`O00.9`	Ectopic pregnancy, unspecified	Used when specific location is not documented but ectopic pregnancy is present.
`R10.9`	Abdominal pain, unspecified	Symptom code often present at initial presentation; supports clinical context.
`O03.9`	Spontaneous abortion, incomplete or unspecified	Sometimes considered in differential diagnosis and perioperative documentation when bleeding/expulsion occurs.
`R79.1`	Abnormal pregnancy test	Supports diagnostic workup when positive beta-hCG prompts imaging and surgical intervention.
`I82.9`	Embolism and thrombosis of unspecified vein	Included as a possible perioperative complication code if venous thromboembolism occurs (coding as appropriate).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploration, laparotomy, exploratory, with or without biopsy(s) (separate procedure)	May be used if an exploratory laparotomy is performed to locate and assess an abdominal ectopic prior to definitive removal.
`58140`	Salpingectomy, unilateral or bilateral, with or without removal of the ipsilateral ovary; for ectopic pregnancy	Used when the ectopic pregnancy is located in a fallopian tube and salpingectomy is performed; may be performed if tubal involvement is found during abdominal exploration.
`58999`	Unlisted procedure, hemato/lymphatic/urinogenital system	May be reported when no precise CPT code fits an unusual abdominal ectopic extraction technique (use with operative note).
`36415`	Collection of venous blood by venipuncture	Common preoperative lab collection code for CBC, type and crossmatch.
`36556`	Introduction of non-tunneled centrally inserted central venous catheter	May be used if central access is required intra- or postoperatively for unstable patients (used selectively per clinical need).

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