2025 CPT code 58267
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Vaginal hysterectomy (removal of uterus and cervix through the vagina) for a uterus weighing 250 grams or less, combined with a procedure to address urinary incontinence (colpourethrocystopexy).
Modifiers may be applicable to 58267. Refer to current CPT modifier guidelines for specific scenarios.
Medical necessity for 58267 requires documentation supporting the need for the hysterectomy and the presence of stress urinary incontinence requiring surgical intervention. This could include symptoms, failed conservative management, and diagnostic findings.
The physician performs a vaginal hysterectomy with concomitant colpourethrocystopexy to address both the uterine issue and the stress urinary incontinence.
In simple words: The surgeon removes the uterus and cervix through the vagina.Since the uterus is small, this approach is possible. Because the patient also leaks urine when coughing or sneezing (stress incontinence), the surgeon also performs a procedure to support the urethra and improve bladder control.
This procedure involves the surgical removal of the uterus and cervix through the vagina (vaginal hysterectomy) when the uterus weighs 250 grams or less. It is performed in conjunction with a colpourethrocystopexy, a procedure to correct stress urinary incontinence by surgically supporting the urethra. This may involve techniques like the Marshall-Marchetti-Krantz or Pereyra methods.An endoscope (a thin, lighted tube with a camera) may be used during the procedure.
Example 1: A 45-year-old woman with a uterus weighing less than 250g and experiencing stress urinary incontinence undergoes a vaginal hysterectomy along with a Marshall-Marchetti-Krantz urethropexy. Code 58267 is reported., A 50-year-old woman with a 200g uterus and stress incontinence chooses to have a vaginal hysterectomy and a Pereyra urethral suspension. Code 58267 is reported., A 52-year-old woman with abnormal uterine bleeding and stress urinary incontinence has a 220g uterus. A vaginal hysterectomy with endoscopic assistance is performed along with a colpourethrocystopexy. Code 58267 is used.
Documentation should include operative report detailing the vaginal hysterectomy, the type of colpourethrocystopexy performed (e.g., Marshall-Marchetti-Krantz, Pereyra), the weight of the uterus, and any endoscopic assistance used. Preoperative and postoperative diagnoses, including stress incontinence, should also be documented.
** Always verify the weight of the uterus from the pathology report as this is critical for correct coding.This code represents a combined procedure and should not be reported separately with codes for vaginal hysterectomy and urethral suspension when performed together.
- Revenue Code: P1E - Major Procedure - Hysterectomy
- RVU: Work RVU for 58267 is 18.36 (as of 2019).For comparison, 58270 has a work RVU of 15.30 and 51840 has 11.36.
- Payment Status: Active
- Fee Schedule: Consult historical Medicare Physician Fee Schedules for past payment information related to 58267.
- Specialties:Obstetrics and Gynecology, Urogynecology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital