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2025 CPT code 49205

Excision or destruction, open, of one or more intra-abdominal tumors, cysts, or endometriomas, involving peritoneal, mesenteric, or retroperitoneal primary or secondary tumors, where the largest tumor is greater than 10.0 cm in diameter.

Refer to CPT guidelines for specific coding instructions. Do not report this code with certain other procedures, as detailed in the alternate_codes_note.Accurate measurement of the largest tumor is crucial for code selection.

Modifiers may be applicable. Refer to current CPT guidelines for modifier usage.

Medical necessity for this procedure must be established through documentation of the patient's symptoms, imaging studies confirming the presence and size of the masses, and the rationale for open surgical intervention.

The physician performs the surgical procedure, including making the incision, examining the abdominal cavity, excising or destroying the tumors, cysts, or endometriomas, irrigating, achieving hemostasis, and closing the incision. The procedure requires specialized knowledge of abdominal anatomy and surgical techniques.

IMPORTANT:Do not report 49203-49205 with 38770, 38780, 49000, 49010, 49215, 50010, 50205, 50225, 50236, 50250, 50290, 58920, 58925, 58940, 58943, 58951-58954, 58956-58960. For partial or total nephrectomy, use 50220 or 50240 with 49203-49205. For colectomy, use 44140 with 49203-49205. For small bowel resection, use 44120 with 49203-49205. For vena caval resection with reconstruction, use 49203-49205 with 37799. For resection of recurrent ovarian, tubal, primary peritoneal, or uterine malignancy, see 58957, 58958. For cryoablation of renal tumors, see 50250, 50593.

In simple words: This procedure involves open surgery to remove or destroy abnormal growths (tumors, cysts, or endometriomas) within the abdomen. The largest growth is bigger than 10 cm.The surgeon makes an incision in the abdomen, examines the area, removes the growths, and closes the incision.

Open surgical excision or destruction of one or more intra-abdominal tumors, cysts, or endometriomas. The procedure targets peritoneal, mesenteric, or retroperitoneal primary or secondary tumors, with the largest tumor exceeding 10.0 cm in diameter.This involves making an abdominal incision (location varies depending on target area), examining organs and structures, excising or destroying the growths, irrigating the area, controlling bleeding, and closing the incision.

Example 1: A patient presents with a large (12 cm) retroperitoneal sarcoma. Code 49205 is reported for the open surgical excision of the tumor., A patient with a history of ovarian cancer undergoes open surgery for the removal of multiple peritoneal metastases, the largest measuring 11 cm. Code 49205 is reported., A patient has a large mesenteric cyst (15 cm) that is causing abdominal pain. Open surgical excision of the cyst is performed, and 49205 is reported.

Documentation should include details of the size and location of the tumors, cysts, or endometriomas, operative report with details of the procedure performed, including the approach, techniques used, and findings. Pre- and post-operative diagnoses should also be documented.

** Laparoscopic equivalent codes are not available for 49203-49205, use unlisted code and benchmark value accordingly.

  • Revenue Code: P1G - Major Procedure - Other
  • Payment Status: Active
  • Specialties:General Surgery, Surgical Oncology, Gynecologic Oncology
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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