CPT Code 58150: Total abdominal hysterectomy billing guide

Key Takeaways

CPT Code 58150 describes a total abdominal hysterectomy (TAH) involving removal of the corpus uteri and cervix, with or without tubes and/or ovaries, via open abdominal incision.

Do not separately report CPT 58700 (salpingectomy) or 58940 (oophorectomy) when performed during the same TAH encounter – NCCI bundling prohibits unbundling these services.

CPT 58150 carries a 90-day global surgical period under Medicare; post-operative visits within that window are included unless a separately identifiable problem arises.

Pabau’s claims management software helps OBGYN practices track modifier usage, manage global period billing, and reduce claim denials on high-value surgical codes like 58150.

CPT code 58150, maintained by the American Medical Association, covers a total abdominal hysterectomy (TAH) of the corpus uteri and cervix, with or without removal of tube(s) and/or ovary(s), via open abdominal incision.

It is distinct from laparoscopic codes (58570–58573) and vaginal approach codes (58260–58294), and belongs to the Hysterectomy Procedures range 58150–58294. OBGYN practices billing this code need reliable OBGYN EMR software to capture procedure details, modifiers, and global period events accurately.

What CPT 58150 includes

The code description’s phrase “with or without removal of tube(s), with or without removal of ovary(s)” means the salpingectomy and oophorectomy components are bundled into 58150 when performed during the same operative session. Reporting CPT 58700 or CPT 58940 separately on the same claim is a NCCI bundling violation.

• Corpus uteri removal: complete excision of the uterine body
• Cervix removal: included as part of the total procedure (distinguishes TAH from supracervical hysterectomy codes like 58180)
• Fallopian tubes (optional): unilateral or bilateral salpingectomy bundled – do not report 58700 separately
• Ovaries (optional): unilateral or bilateral oophorectomy bundled – do not report 58940 separately

CPT code 58150 vs. related hysterectomy codes

Selecting the wrong code in the TAH family is a frequent audit trigger. The table below maps the most commonly confused codes to their key differentiators.

A practical rule: if the operative note documents an abdominal incision and removal of both corpus and cervix, the base code is 58150. If the cervix was spared, use 58180. If the approach was laparoscopic, move to the 58570–58573 range. Dedicated practice scheduling and documentation software that captures approach and specimen details at time-of-service reduces downstream coding errors.

Modifiers for 58150

Three modifiers apply most frequently to CPT 58150.

Modifier 22 — Increased procedural complexity

Modifier 22 applies when the TAH involved substantially more work than usual. SGO coding guidance points to 58150-22 for cases like lysis of dense adhesions (with no separate debulking procedure). To get paid, payers usually want an operative note that spells out the extra time and the specific factors that made the case harder.

Common qualifying scenarios include: dense pelvic adhesions from prior surgeries or endometriosis, a significantly enlarged or fibroid uterus that substantially increases operative time, and unusual anatomical distortion requiring extended dissection. When adhesiolysis is instead performed as a stand-alone laparoscopic procedure, it maps to laparoscopic lysis of adhesions (58660), not 58150-22.

Most payers require a cover letter with the claim explaining the basis for Modifier 22; expect some to request the full operative note before adjusting reimbursement upward.

Modifier 52 — Reduced services

Use Modifier 52 when the planned TAH was intentionally reduced in scope at the surgeon’s discretion before the procedure was fully completed. This differs from a complication that stopped the case; it reflects an elective decision to perform less than the full service described by the code.

Modifier 59 — Distinct procedural service

Modifier 59 is used when a second procedure performed on the same date is distinct from the TAH and would otherwise be bundled incorrectly by the payer’s editing system.

Apply it carefully: CMS expects documentation showing the procedure was performed on a different anatomical site or represented a separate patient encounter. Using 59 to override a legitimate NCCI edit is a compliance risk.

NCCI edits and bundling rules

The CMS National Correct Coding Initiative (NCCI) explicitly prohibits unbundling the components of a total abdominal hysterectomy. Understanding which codes cannot be reported alongside CPT 58150 prevents the most common denial reasons for this procedure.

Codes bundled into CPT 58150 — Do not report separately

• CPT 58700 (salpingectomy): The CMS NCCI 2000 Coding Policy Manual explicitly states that separately reporting 58700 and 58940 when these are performed in the course of a hysterectomy is prohibited unbundling.
• CPT 58940 (oophorectomy): Bundled when performed during the same TAH session; not reportable separately under the same encounter.
• CPT 58146: Per the CMS NCCI Correspondence Language Manual (effective February 28, 2025), CPT 58146 is not separately reportable in addition to CPT codes 58140-58145 or 58150-58240.

CPT 58150 and 58140 (myomectomy)

Billing CPT 58150 and CPT 58140 together on the same date requires careful review against current NCCI edits before submission. The clinical rationale would need to be clearly documented if a myomectomy and a total hysterectomy were separate procedures on distinct anatomical targets.

Verify the current NCCI edit table for this pair before submitting, as edit status can change with quarterly updates. Tracking accurate procedure pairing is one area where purpose-built claims management software adds measurable value.

Reduce surgical claim denials with Pabau

Pabau's claims management tools help OBGYN practices track modifier usage, flag NCCI bundling conflicts, and manage global period billing – so fewer 58150 claims come back as denials.

Book a demo

Reimbursement and fee schedule

Medicare reimbursement for CPT 58150 is calculated using Relative Value Units (RVUs) from the CMS Physician Fee Schedule. The total payment reflects work RVUs, practice expense RVUs, and malpractice RVUs, each adjusted by the geographic practice cost index (GPCI) for the practice location.

Commercial payer rates for 58150 vary significantly by contract. Some payers use a percentage of the Medicare fee schedule (often 110-150%), while others negotiate flat rates per procedure. Always verify your contract terms for major surgical codes rather than assuming Medicare-equivalent rates apply.

Global period and post-operative care

CPT Code 58150 carries a 90-day global surgical period under the Medicare Physician Fee Schedule. This means the surgeon’s fee bundles all routine post-operative care from the day before surgery through 90 days after the procedure.

What is included in the 90-day global period

• All office visits related to recovery from the TAH during the 90-day window
• Wound checks, suture removal, routine follow-up for pain or swelling
• Management of minor post-operative complications that do not require a return to the OR

What can be billed separately during the global period

• New, unrelated conditions: A visit for an entirely separate diagnosis (e.g., a urinary tract infection that requires evaluation beyond routine post-op care) can be billed with Modifier 24 appended to the E/M code.
• Return to the OR: A second surgery for a complication (e.g., evacuation of a hematoma) is separately billable with Modifier 78.
• Staged procedures: A procedure planned from the outset as a staged follow-up uses Modifier 58.

Tracking which visits fall inside the 90-day window — and whether each qualifies for separate billing — requires consistent documentation at the point of care. Surgical scheduling workflows that flag active global periods for returning patients reduce over-billing risk. HIPAA-compliant records for every post-operative encounter support audit defense if payers question global period billing decisions.

Documentation requirements

Thorough operative documentation is the most effective denial-prevention strategy for 58150 claims. Payers auditing this code look for specific elements that confirm medical necessity, support the approach chosen, and justify any modifiers appended.

Operative note essentials

• Approach: Explicitly state “open abdominal approach via [Pfannenstiel/midline] incision” to distinguish from laparoscopic or vaginal codes
• Structures removed: List corpus uteri, cervix, and any tubes or ovaries removed; note which were retained if any
• Indication: State the primary diagnosis (e.g., uterine fibroids, endometrial carcinoma, AUB) that drove the decision for hysterectomy
• Complexity factors: If Modifier 22 is appended, quantify additional operative time and describe complicating findings (adhesion grade, uterine weight if enlarged)
• Specimen handling: Note pathology submission, laterality of adnexal structures removed

Standardized surgical documentation forms reduce the risk of omitting these elements. Digital intake forms and procedure templates — for example, a pelvic exam documentation template — that prompt for approach, structures removed, and complexity factors help ensure nothing is missed before the claim is submitted.

Every operative record must be stored securely with audit-ready access controls per HIPAA requirements. For practices also handling oncologic pelvic procedures requiring implantable materials, the HCPCS Code C1781 implantable mesh billing guide is a useful companion reference.

ICD-10 diagnosis codes paired with 58150

Medical necessity for a TAH is established by the linked ICD-10-CM diagnosis code. The primary diagnosis must justify the procedure under the payer’s coverage policy, and supporting workups such as a pelvic ultrasound help document that necessity. Common pairings include:

• D25.9 – Leiomyoma of uterus, unspecified (uterine fibroids)
• N92.0 / N92.1 – Excessive and frequent menstruation with regular cycle (N92.0) / irregular cycle (N92.1)
• N80.03 – Adenomyosis of uterus
• N80.101 / N80.102 / N80.103 – Endometriosis of right / left / bilateral ovary
• C54.1 – Malignant neoplasm of endometrium
• N85.2 – Hypertrophy of uterus
• N81.2 / N81.3 – Uterovaginal prolapse (incomplete / complete)

Always assign the most specific ICD-10-CM code available. Unspecified codes (e.g., N93.9) draw scrutiny and may trigger medical necessity review. Cross-reference the selected diagnosis against the payer’s applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) before submitting.

Related CPT codes for OBGYN hysterectomy billing

Understanding the full hysterectomy code family helps coders select the right code and cross-reference adjacent procedures. Practices that also bill for fertility-related services may find the IVF CPT codes reference useful alongside gynecologic surgical codes. Standardizing how these codes are captured in a gynecology EHR reduces selection errors across the family.

• 58150: Total abdominal hysterectomy (TAH), with or without tubes/ovaries (open approach)
• 58152: TAH with colpo-urethrocystopexy – adds a bladder neck suspension; use when Marshall-Marchetti-Krantz or Burch procedure is documented
• 58180: Supracervical abdominal hysterectomy – corpus only; cervix retained
• 58200: TAH with partial vaginectomy and lymph node sampling – oncologic staging procedure
• 58210: Radical abdominal hysterectomy with pelvic lymphadenectomy and para-aortic dissection – used for cervical or endometrial malignancies requiring wider resection
• 58571: Laparoscopic TAH with tubes/ovaries, uterus 250 g or less – the laparoscopic equivalent; do not use 58150 for laparoscopic cases
• 58573: Laparoscopic TAH with tubes/ovaries, uterus over 250 g – distinguishes uterine weight above the threshold

For practices managing gynecologic oncology billing alongside general OBGYN, standardized surgical documentation forms that capture procedure type, approach, and specimen weight at time-of-service prevent the most common code-selection errors in this family.

Summary

Denials on CPT code 58150 are almost always preventable. When complex reconstructive procedures accompany oncologic resection, the CCSD Code T7602 microvascular free tissue transfer billing guide and the CPT Code 50825 continent diversion billing guide provide additional coding context for multi-procedure surgical claims.

The most common causes are NCCI bundling violations (separately billing 58700 or 58940), missing Modifier 22 documentation, and ICD-10 codes that do not establish medical necessity with the payer. Catching these before submission rather than resolving them on appeal saves significant time and revenue.

Pabau’s automated billing workflows help OBGYN practices flag modifier requirements, track global period windows, and maintain audit-ready documentation for high-value surgical codes. Book a demo to see how Pabau handles surgical billing for OBGYN practices.

Continue your research

Want to catch missing documentation before claims go out? Digital forms covers how Pabau’s customizable procedure templates prompt for operative details that support correct code selection and modifier use.

Continue your research: browse our latest coding guides, including critical care CPT code 99291 and CPT 97804 for medical nutrition therapy.

Frequently Asked Questions