2025 CPT code 58290
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Vaginal hysterectomy for a uterus weighing more than 250 grams.
Modifiers may be applicable depending on circumstances, such as multiple procedures (modifier 51), reduced services (modifier 52), or distinct procedural service (modifier 59).Consult the CPT guidelines and NCCI edits.
Medical necessity for a vaginal hysterectomy (58290) is established when conservative management options have failed to alleviate symptoms, and the patient experiences significant impairment in their quality of life due to conditions such as heavy menstrual bleeding, pelvic pain, or uterine prolapse.The size of the uterus should also be considered when determining medical necessity.Documentation supporting medical necessity should be thorough.
The physician's responsibilities include pre-operative examination, administering anesthesia, performing the vaginal hysterectomy, and post-operative care.The surgeon must ensure accurate assessment of uterine size and appropriate surgical technique.
In simple words: The doctor removes the uterus and cervix through the vagina. This is done when the uterus is larger than normal, often because of fibroids, making it heavier than 250 grams.The doctor will carefully remove the uterus and repair the area.
This procedure involves the surgical removal of the uterus and cervix through the vagina.It is specifically indicated when the uterus weighs more than 250 grams, often due to fibroids. The procedure includes detaching the uterus from surrounding structures, removal through the vaginal canal, and repair of the vaginal cuff.
Example 1: A 45-year-old woman presents with heavy menstrual bleeding and pelvic pain due to large uterine fibroids.The uterus weighs 300g.A vaginal hysterectomy (58290) is performed., A 50-year-old woman with a history of uterine prolapse undergoes a vaginal hysterectomy (58290).The uterus weighs 275g., A 38-year-old woman with severe endometriosis and a 350g uterus undergoes a vaginal hysterectomy (58290). The procedure includes repair of the vaginal cuff.
Preoperative evaluation including patient history, physical examination, and imaging studies (ultrasound, MRI). Operative report detailing the surgical approach, estimated weight of the uterus, and any complications or additional procedures performed.Pathology report confirming the weight of the removed uterus and any findings. Postoperative progress notes.
** Always verify the weight of the uterus from the pathology report to ensure accurate code selection.Consider other CPT codes if additional procedures are performed during the hysterectomy.
- Revenue Code: P1E (Major Procedure - Hysterectomy)
- RVU: Information not available in provided sources. RVUs vary by payer and geographic location.
- Global Days: Information not available in provided sources. Global surgical days vary based on payer and procedure specifics.
- Payment Status: Active
- Modifier TC rule: Not applicable for this code.
- Fee Schedule: Information not available in provided sources. Fee schedules vary by payer and location.
- Specialties:Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital