Summary & Overview
CPT 59525: Cesarean Delivery with Subtotal (Partial) Hysterectomy
CPT code 59525 denotes a cesarean delivery performed with a concurrent subtotal (partial) hysterectomy, in which the uterus is removed while the cervix is left intact. This code captures a high-acuity obstetric surgical service commonly required for severe intrapartum or postpartum complications that cannot be managed with uterine-sparing techniques. Nationally, accurate use of this code affects hospital surgical case mix, maternal morbidity reporting, and reimbursement for complex obstetric care.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for 59525, standard sites of service, and typical service classification. The publication also provides benchmarks for coding and billing practices, discussion of payer coverage patterns, and relevant policy considerations impacting claims processing and reimbursement for combined cesarean and hysterectomy procedures.
This summary highlights what clinicians and coding professionals need to know about proper application of CPT code 59525, how it is distinguished from isolated cesarean or hysterectomy codes, and the implications for hospital reporting and payer adjudication. Data not available in the input will be noted where applicable in detailed sections.
Billing Code Overview
CPT code 59525 describes a cesarean delivery with concurrent subtotal (partial) hysterectomy, where the provider performs a cesarean birth and surgically removes the uterus during the same operative session, leaving the cervix in place. This procedure is typically performed when maternal indications arise during or immediately after delivery that require removal of the uterus while preserving the cervix.
Service Type: Surgical obstetric procedure
Typical Site of Service: Hospital operating room or other inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A 32-year-old G2P1 patient presents in active labor with a nonreassuring fetal heart tracing and a history of previous cesarean delivery. The obstetric team proceeds with an urgent repeat cesarean delivery in the operating room under regional anesthesia. Intraoperatively, the surgeon identifies extensive uterine atony and uncontrolled hemorrhage refractory to uterotonics and conservative measures. To control bleeding and stabilize the patient, the provider performs a subtotal (partial) hysterectomy at the same operative session as the cesarean delivery, removing the uterine corpus while leaving the cervix in place. The immediate perioperative workflow includes maternal stabilization, anesthesia management, surgical time-out, cesarean delivery of the neonate, uterine repair attempts, conversion to hysterectomy, estimated blood loss assessment, transfusion as needed, and postoperative monitoring in the recovery unit with obstetric and critical care follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the subtotal hysterectomy required significantly greater effort, time, or risk than usual (e.g., dense adhesions, extensive hemorrhage) and documentation supports increased work. |
23 |