CPT code 58572 – Laparoscopic total hysterectomy

Key takeaways

CPT 58572 reports a total laparoscopic hysterectomy for a uterus greater than 250 g, with no removal of tubes or ovaries

Uterine weight separates 58572 from 58570, and the signed pathology report is the only source for that weight

Adnexal removal separates 58572 from 58573, so any tube or ovary removed in the same session moves the claim to 58573

Never add 58661 or 58700 to 58572 for tube or ovary removal, because 58573 already describes that combination

Pabau, the practice management platform we build, keeps the operative note and pathology report on one patient file and submits claims electronically through Claim.MD

CPT Code 58572: Official descriptor and procedure overview

The American Medical Association defines CPT Code 58572 as Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g. It belongs to the 58570-58573 family of total laparoscopic hysterectomy (TLH) codes in the AMA CPT code set.

Two variables split that family: the weight of the uterus and whether any tube or ovary comes out. 58572 is the large-uterus code with the tubes and ovaries left in place.

The approach must be fully laparoscopic, including detachment of the cervix. A laparoscopically assisted vaginal hysterectomy uses 58550-58554, and a laparoscopic supracervical hysterectomy uses 58541-58544. A case that converts to an open incision is reported with an open hysterectomy code such as 58150 instead.

What the code includes and excludes

Bundling rules matter on this code. The costliest error is adding a second code for work that another member of the TLH family already describes.

Included in 58572:

• Total laparoscopic removal of the uterus and cervix
• Diagnostic laparoscopy at the same session, so CPT 49320 is not reported separately
• Lysis of adhesions needed to reach and complete the hysterectomy
• Routine hemostasis, specimen retrieval, including morcellation, and closure
• The 90-day global surgical period: preoperative visits the day before and the day of surgery, plus related postoperative care through day 90

Not included, or a sign that a different code applies:

• Removal of any fallopian tube or ovary: this is not an add-on to 58572. Report 58573 alone, never 58572 plus 58661 or 58700.
• Laparoscopic colpopexy (CPT 57425) or another prolapse repair: may be separately reportable when documented as a distinct procedure. Check the NCCI procedure-to-procedure edits first.
• Extensive adhesiolysis that adds substantial work: report it with modifier 22 on 58572 rather than with a separate adhesiolysis code.

Check the current quarterly NCCI procedure-to-procedure edits before you report any second code alongside 58572. The edits update every quarter.

CPT 58572 vs CPT 58570: When uterine weight changes the code

58570 and 58572 describe the same procedure, a TLH with the tubes and ovaries left in place. The only difference is weight: 250 g or less for 58570, greater than 250 g for 58572.

The pathology report is the authoritative source for that weight. An intraoperative estimate or an ultrasound measurement does not support the code. If pathology records 250 g or less, the claim belongs on 58570, even when the uterus looked large on imaging.

Hold the claim until the final pathology report is signed. Coding from the estimate in the operative note invites a recoupment when pathology comes back lighter.

CPT 58572 vs CPT 58573: When tube or ovary removal changes the code

58572 and 58573 share the same weight band, greater than 250 g. 58573 adds removal of one or more fallopian tubes and/or ovaries in the same session.

That includes an opportunistic salpingectomy performed to lower ovarian cancer risk. If the surgeon removed even a single tube with a uterus over 250 g, the code is 58573, not 58572.

Reporting 58572 plus 58661 for that case is unbundling, and NCCI edits deny it. The single code 58573 already captures both components.

Put the two questions side by side and the four TLH codes read as one decision.

Documentation that supports a 58572 claim

Payer review of 58572 claims focuses on three facts: a fully laparoscopic approach, a uterus over 250 g, and no adnexal removal. Your workflow should capture all three before the claim leaves the practice.

The following elements must appear in the clinical record to support a 58572 claim:

• Operative report: states total laparoscopic hysterectomy, confirms every step was completed laparoscopically, and records that the tubes and ovaries were left in place.
• Pathology report: records a uterine specimen weight above 250 g, including all fragments after morcellation.
• Diagnosis codes: ICD-10-CM codes that establish medical necessity, as covered in the section below.
• Setting records: confirm that the operative setting matches the place-of-service code on the claim.
• Prior authorization number: included on the claim when the payer required one.

A structured operative note template records these facts while the surgeon is still writing. A required field asking whether the adnexa were preserved stops the 58572-versus-58573 error before coding starts.

Modifiers used with 58572

Modifiers explain circumstances that the code alone cannot convey. The wrong modifier, or a missing one, changes payment and can trigger a payer audit.

Modifier 22 carries a documentation burden. The operative note should name the cause and quantify the extra work. Record, for example, the added time spent on dense adhesions from a prior cesarean section.

Payer requirements and prior authorization

Prior authorization rules for 58572 vary by payer and change often. Authorization is one of the front-end steps in medical billing, and a missing one denies an otherwise correct claim.

Key considerations by payer type:

• Medicare: original Medicare has no national prior authorization program for hysterectomy. Your Medicare Administrative Contractor (MAC) can still apply medical necessity review, so check its local policies.
• Medicare Advantage and commercial insurers: most require prior authorization for hysterectomy. Confirm the payer portal, the required clinical notes, and the turnaround time before you schedule the case.
• Medicaid: state programs set their own prior authorization rules for CPT 58572. Federal Medicaid rules also require a signed acknowledgment that the patient was told the hysterectomy ends fertility, with limited exceptions.
• Medical necessity thresholds: most payers expect documented failure of conservative treatment, such as hormonal therapy, before they approve a benign hysterectomy.

Treat each payer policy as its own rule set. Check the current authorization grid or coverage policy for every case rather than relying on last year’s answer.

Medicare reimbursement and RVUs for CPT 58572

CPT Code 58572 carries a 90-day global surgical period under the Medicare Physician Fee Schedule (MPFS). Related services by the same surgeon during that window are not billed separately.

Use the CMS Physician Fee Schedule Look-Up Tool to retrieve the current national payment for 58572. Payment is adjusted by the Geographic Practice Cost Index (GPCI) for each locality.

For 2026, CMS publishes two conversion factors: $33.5675 for qualifying APM participants and $33.4009 for everyone else. Confirm which one applies to the billing clinician before you project revenue.

Hysterectomy is performed in a hospital or ambulatory surgery center, so the surgeon is paid the facility rate. The facility bills its own fee separately for the overhead.

ICD-10 codes that establish medical necessity

Every CPT 58572 claim needs at least one ICD-10-CM code that establishes medical necessity. Payers check the diagnosis against their accepted indications, and an unsupported code denies automatically.

Payer coverage lists may exclude some subcodes or require more specificity than the category level. Review the payer policy before you finalize the diagnosis link, and code the condition at the highest specificity the record supports.

Bleeding codes show why. An unspecified code such as N93.9 rarely carries a hysterectomy on its own. Pair it with the fibroid or adenomyosis code that the pathology report supports.

Common denial reasons and how to avoid them

Most 58572 denials trace to one of six root causes. Each one has a fix you can build into the pre-submission workflow.

• Wrong code for tube or ovary removal: 58572 billed when a tube or ovary came out. Read the operative note before code assignment, and report 58573 when any adnexal structure was removed.
• Weight not supported: the pathology report is missing, or it records 250 g or less. Hold the claim until the signed report arrives, and switch to 58570 if the weight does not clear 250 g.
• Missing or mismatched ICD-10: the diagnosis must match an accepted indication in the payer policy. Build the check into the denial management workflows your practice already uses.
• Failed prior authorization: the authorization number must appear exactly as issued. Confirm that the authorization covers 58572 itself, not only a general hysterectomy category.
• Unbundling 58661 or 58700: pairing either code with 58572 triggers an NCCI edit. The correct single code for that combination is 58573.
• Place-of-service mismatch: an ASC case billed with an inpatient code, or the reverse, will deny. Match the place-of-service code to the actual operative setting.

A pre-submission check of these six points catches most avoidable 58572 denials. Make it a required step in the claim workflow so no coder can skip it under deadline pressure.

Related CPT codes

These codes sit next to 58572 in the AMA Laparoscopy/Hysteroscopy subsection or come up in the same claims. Match the code to the approach, the uterine weight, and what was removed.

How Pabau supports TLH billing

Most 58572 errors start before a claim exists. The weight sits in a pathology report, the adnexal detail sits in an operative note, and the coder works from a third screen. Pabau keeps those records on one patient file.

Pabau’s electronic claims management submits the claim through Claim.MD, our US clearinghouse integration. Claim.MD returns Electronic Remittance Advice (ERA) data, so payer responses and denial reason codes appear in Pabau.

Your coders still make the code call. Pabau puts the operative note, the pathology report, and the signed consent form in front of them when they do.

Keep TLH documentation and claims on one record

Pabau keeps operative notes, pathology reports, and consent forms on the patient record. Claims go out electronically through Claim.MD, and ERA data comes back into the same system.

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Conclusion

CPT Code 58572 turns on two facts: a uterus heavier than 250 g on the pathology report, and tubes and ovaries left in place. Get the weight wrong and the claim belongs on 58570. Miss a removed tube and it belongs on 58573.

Code from the signed pathology report and the operative note, never from an estimate. That one habit prevents most recoupments across the TLH family. Book a demo to see how Pabau keeps the records behind each TLH claim in one place.

Continue your research

Billing a smaller uterus with tube or ovary removal? CPT code 58571 covers the 250 g or less TLH code with adnexal removal.

Did the case convert to an open incision? CPT code 58150 covers total abdominal hysterectomy and the documentation it needs.

Want to reduce denials across your surgical code set? Denial management in healthcare covers the core workflows for preventing and working denials.

Leaving the cervix in place? CPT code 58542 covers laparoscopic supracervical hysterectomy for a uterus of 250 g or less with tube or ovary removal.

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