2025 CPT code 58146
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Myomectomy, excision of 5 or more intramural uterine fibroids and/or intramural fibroids with a total weight greater than 250 grams, performed via an abdominal approach.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), or other situations outlined in CPT modifier guidelines.
Medical necessity for 58146 must be established by documenting the symptoms caused by the fibroids, such as heavy menstrual bleeding, pelvic pain, or pressure on other organs. The documentation should clearly indicate that the symptoms are significant enough to warrant surgical intervention.
The physician is responsible for the complete surgical procedure, including pre-operative planning, the myomectomy itself, post-operative care, and management of any complications.
In simple words: This procedure removes five or more, or a combined weight of over 250g, fibroid tumors from the wall of the uterus through an incision in the abdomen.
This procedure involves the surgical removal of five or more fibroid tumors embedded within the muscular wall (myometrium) of the uterus, or the removal of intramural fibroids with a combined weight exceeding 250 grams.The procedure is performed through an abdominal incision.The surgeon exposes the uterus, identifies the fibroids, and excises them.The uterine wall is then repaired, bleeding is controlled, and the abdominal incision is closed.
Example 1: A 35-year-old woman presents with heavy menstrual bleeding and pelvic pain. Ultrasound reveals five intramural fibroids.She undergoes an abdominal myomectomy (58146) for symptom relief and preservation of fertility., A 42-year-old woman has three large intramural fibroids with a combined weight of 280 grams causing significant pressure and discomfort.She elects to have an abdominal myomectomy (58146)., A 48-year-old woman with symptomatic, large fibroids desires to retain her uterus.An abdominal myomectomy (58146) is performed to remove the fibroids while avoiding hysterectomy.
Documentation should include the number and size of fibroids, their location within the uterus (intramural), the total weight if applicable, the surgical approach (abdominal), operative details, and any complications. Pre-operative imaging reports should also be included.
** It is important to accurately document the number and/or total weight of fibroids removed to support the use of code 58146. The specific criteria for using this code (5 or more fibroids or total weight > 250g) must be met. For cases not meeting these criteria, alternative myomectomy codes (e.g., 58140, 58145) may be more appropriate.
- Revenue Code: P1G - Major Procedure - Other
- Payment Status: Active
- Specialties:Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center