Summary & Overview
CPT 59870: Vaginal Removal of Uterine Placental-Type Tissue
CPT code 59870 represents the vaginal removal of an abnormal intrauterine growth arising from excessive placental-type tissue. Nationally, this code captures surgical management of molar or retained placental tissue via vaginal evacuation, a clinically important procedure for treating abnormal gestational trophoblastic growths and resolving associated hemorrhage or infection. Payers commonly involved in coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication outlines what CPT code 59870 denotes clinically and operationally, and provides readers with a concise guide to the service context, site-of-service considerations, and payer coverage landscape. Readers will find benchmarks and comparative payment context where available, a summary of common billing modifiers (provided separately), and clinical context that explains when the vaginal evacuation approach is used versus alternate management strategies. The content is designed for billing professionals, practice managers, and policy analysts seeking a clear national overview of coding, site-of-service, and payer coverage for this specific gynecologic surgical procedure.
Billing Code Overview
CPT code 59870 describes removal of an abnormal growth within the uterus that results from excess placental-type tissue. The procedure is performed through the vaginal canal and involves surgical evacuation of the uterine cavity to remove the abnormal tissue.
-
Service type: Surgical evacuation of uterine tissue (vaginal approach)
-
Typical site of service: Ambulatory surgery center or hospital operating room with vaginal access; may also occur in an inpatient obstetric/gynecologic unit depending on clinical circumstances.
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman of reproductive age who presents with abnormal uterine bleeding, pelvic pain, or rapidly enlarging uterine size following a recent pregnancy or spontaneous abortion. Ultrasound evaluation demonstrates uterine enlargement with heterogeneous intrauterine tissue and Doppler flow suspicious for hydatidiform mole or retained products of conception. The gynecologic team counsels the patient on management and schedules an operative procedure for uterine evacuation via the vaginal canal under either regional or general anesthesia.
Preoperative workflow includes informed consent, pregnancy testing if applicable, blood type and screen (with Rh immunoglobulin administration if indicated), baseline labs, and ultrasound confirmation. In the operating room or procedure suite, the patient undergoes cervical dilation and suction curettage or sharp curettage as indicated to remove the abnormal trophoblastic tissue. The specimen is sent to pathology for histologic confirmation. Postoperative management includes monitoring for hemorrhage, pain control, serial quantitative beta-hCG measurements until undetectable for gestational trophoblastic disease, and counseling on contraception and follow-up care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when services are substantially greater than typical for 59870 due to complexity or prolonged procedure. |