CPT Code 58700: Salpingectomy Billing Guide 2026

Key Takeaways

CPT Code 58700 covers open salpingectomy, complete or partial, unilateral or bilateral, performed as a separate procedure

58700 is for disease-process removal (ectopic pregnancy, BRCA risk) – ACOG guidance explicitly states it should NOT be used for elective sterilization

Modifier 50 cannot be appended: bilateral is already built into the code descriptor, and doing so risks overpayment or claim rejection

Pabau’s claims management software helps OB/GYN practices track modifier rules and ICD-10 pairings to reduce denial rates

Salpingectomy claims generate a disproportionate share of OB/GYN billing denials. The reason is almost always the same: coders use CPT Code 58700 when a different code applies, append modifier 50 when the descriptor already covers bilateral procedures, or pair the wrong ICD-10 diagnosis code with the claim. Each error delays payment and creates audit exposure. According to the American Medical Association, CPT codes are maintained as a standardized language for reporting medical procedures, and 58700 falls within the Excision Procedures on the Oviduct/Ovary range (58700-58720). Getting the code selection right matters from the first submission.

This guide covers the official descriptor for CPT Code 58700, how it differs from laparoscopic and add-on alternatives, modifier rules, ICD-10 pairings, and 2025 Medicare reimbursement guidance.

CPT Code 58700: Procedure Description and Clinical Definition

The official descriptor for CPT Code 58700, as maintained by the AMA, reads: Salpingectomy, complete or partial, unilateral or bilateral (separate procedure). The procedure involves surgical removal of one or both fallopian tubes through an open abdominal incision. It is not a laparoscopic code. When the surgeon accesses the pelvic cavity through a traditional abdominal opening rather than through trocar ports, 58700 is the correct code to report, provided no other major pelvic surgery was performed concurrently that subsumes this work.

The parenthetical “(separate procedure)” is a critical modifier in the descriptor itself. Under CPT guidelines, this designation means the code should only be reported when the salpingectomy stands alone as the primary surgical event. If the fallopian tube removal occurs as an incidental component of a larger procedure, the work is typically bundled into the primary code and 58700 is not separately billable. For gynecologic surgical coding across a range of tube and ovary procedures, understanding this bundling logic is foundational.

Scope of the Procedure

58700 captures both complete and partial excision. A complete salpingectomy removes the entire tube; a partial salpingectomy removes a segment. Both fall within the same code. The descriptor also explicitly covers unilateral and bilateral approaches, which has direct implications for modifier usage (see Billing Guidelines below).

Clinical Indications and Appropriate Use

Appropriate use of 58700 depends on the clinical reason for the salpingectomy. Three indications are well-established in coding guidance:

• Ectopic pregnancy: When a fertilized egg implants in the fallopian tube rather than the uterus, open salpingectomy may be required to manage the complication. This is a disease-process removal and 58700 applies.
• Pathologic conditions: Hydrosalpinx, chronic pelvic inflammatory disease, or other non-inflammatory disorders of the fallopian tube (ICD-10 category N83) are appropriate indications for reporting this code.
• Risk-reducing salpingectomy: Patients with confirmed BRCA1 or BRCA2 mutations may undergo prophylactic tube removal to reduce ovarian cancer risk. This is a medically indicated procedure and qualifies for 58700.

What 58700 is not for: Elective sterilization. The American College of Obstetricians and Gynecologists (ACOG) issued explicit guidance that CPT Code 58700 should not be reported when the purpose of the salpingectomy is sterilization. Misapplying the code in a sterilization context creates compliance risk, particularly for Medicaid claims where sterilization requires a separate consent process. OB/GYN practices that bill 58700 for sterilization purposes face denial risk and potential audit exposure.

CPT Code 58700 vs Related Codes: 58661, 58611, and 58720

Code selection errors in salpingectomy billing almost always involve one of three adjacent codes. Each describes a distinct clinical scenario.

58700 vs 58661: Open vs Laparoscopic

The distinction between 58700 and 58661 is surgical approach. If the surgeon makes an abdominal incision, use 58700. If the procedure is performed through laparoscopic ports, use 58661. This is not a gray area. Reporting 58700 for a laparoscopic salpingectomy is incorrect coding, and payers cross-reference operative reports against code selection.

58700 vs 58611: The C-Section Add-On Distinction

This is the most commonly cited error in OB/GYN salpingectomy billing. When a salpingectomy for sterilization is performed at the time of a cesarean section, the correct code is 58611 (an add-on code), not 58700 as a standalone separate procedure. ACOG issued guidance specifically on this point, and the AAPC Ob-Gyn Coding Alert reinforced it. Reporting 58700 with a C-section code for sterilization purposes misrepresents the procedure as a disease-process salpingectomy and violates coding guidelines.

Billing Guidelines and Modifier Rules

Three modifier questions come up repeatedly in 58700 billing. Each has a definitive answer.

Modifier 50 (Bilateral Procedure): Cannot Be Used

Modifier 50 signals a bilateral procedure performed during the same operative session. For most surgical codes, appending modifier 50 informs the payer that both sides were operated on and adjusts reimbursement accordingly. 58700 is an exception. Because the descriptor already reads “unilateral or bilateral,” the code inherently covers both scenarios. Appending modifier 50 to CPT Code 58700 is incorrect and will result in either claim rejection or overpayment recovery. The American Association of Gynecologic Laparoscopists (AAGL) has published explicit coding guidance confirming this rule. A strong claims management workflow flags modifier 50 as ineligible for this code at the point of entry.

Modifier 51 (Multiple Procedures)

When 58700 is performed alongside another surgical procedure in the same session, modifier 51 may apply to the secondary procedure to indicate multiple surgeries. Always verify the applicable NCCI edits before reporting 58700 with any concurrent procedure, particularly oophorectomy (58720), where bundling rules may restrict separate billing.

Place of Service

58700 is typically performed in a hospital outpatient setting or an ambulatory surgery center (ASC). Place of Service codes affect the facility vs non-facility RVU calculation, which in turn affects the reimbursement rate. Use POS 22 for hospital outpatient and POS 24 for ASC. Report POS accurately, as payers audit this field against procedure complexity.

ICD-10 Diagnosis Codes for Salpingectomy

Diagnosis code selection determines medical necessity. The ICD-10 code must match the documented clinical indication, not the surgical technique. Common pairings for CPT Code 58700 include:

• O00 series (Ectopic pregnancy): O00.10 (tubal pregnancy without intrauterine pregnancy), O00.11 (with intrauterine pregnancy), and related subcategories cover the most acute indication for 58700.
• N83 series (Non-inflammatory disorders of ovary, fallopian tube, and broad ligament): N83.0 (follicular cyst), N83.1 (corpus luteum cyst), N83.5 (torsion), and related codes apply for pathologic tube conditions.
• Z31.83 or Z40 series (Prophylactic removal): For BRCA-related risk-reducing salpingectomy, Z40.02 (encounter for prophylactic removal of ovary and fallopian tube) supports medical necessity.
• Z30.2 (Encounter for sterilization): This diagnosis code is used when sterilization is the intent, but it must be paired with the correct CPT code (58611 or 58565), not 58700.

Pairing Z30.2 with 58700 is a common coding error. It signals sterilization intent while reporting a disease-process code, creating a mismatch that payers flag during claims review. Fertility and reproductive health clinics handling a mix of sterilization and pathologic salpingectomy cases should build payer-specific edit rules into their billing workflow to catch this pairing before submission.

Documentation Requirements for Clean Claim Submission

An operative report that clearly supports the claim is the foundation for reimbursement. For CPT Code 58700, the documentation must establish four things:

1. Surgical approach: The report must document open abdominal access, distinguishing the procedure from a laparoscopic approach (58661). If the report describes trocar placement, the code is wrong.
2. Extent of resection: Complete or partial. The operative note must describe whether the entire tube or a segment was removed.
3. Laterality: Unilateral or bilateral. Since the code covers both, the note must specify which side(s) were operated on. This is essential for NCCI compliance and payer audit response.
4. Clinical indication: The indication must align with the ICD-10 code reported. If the note documents ectopic pregnancy, the claim should carry an O00 code. If the note indicates sterilization, 58700 should not be on the claim.

Complete digital intake and documentation systems that capture operative details at the point of care reduce transcription errors between the clinical record and the billing submission. Practices should also ensure their documentation workflow meets HIPAA-compliant documentation standards for record retention and access controls.

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Medicare and Medicaid Reimbursement

Reimbursement rates for CPT Code 58700 vary by payer, geographic location, and place of service. The CMS Medicare Physician Fee Schedule lookup tool provides the most current reimbursement values by locality. Rates change annually with each Medicare Physician Fee Schedule update, so any specific dollar figure cited from a prior year may no longer reflect current allowables.

Medicare Coverage Limits

Medicare does not cover sterilization procedures. CMS Article A53356 in the Medicare Coverage Database addresses sterilization non-coverage explicitly. A claim for 58700 submitted to Medicare with a sterilization diagnosis code (Z30.2) will be denied. For disease-process salpingectomies – ectopic pregnancy, pathologic tube conditions, or prophylactic removal in BRCA carriers – Medicare coverage depends on standard medical necessity criteria and supporting documentation.

Medicaid Sterilization Consent Requirements

When sterilization is the documented intent and Medicaid is the payer, federal regulations under 42 CFR 50 Subpart B require a signed federal Consent for Sterilization Form (HHS-687). The patient must be at least 21 years old at the time consent is given, must be mentally competent, and must not be institutionalized or in labor/seeking abortion when consenting. The procedure must occur at least 30 days but not more than 180 days after the consent form is signed, with narrow exceptions for premature delivery or emergency abdominal surgery where at least 72 hours must have elapsed. Medicaid claims for sterilization without a properly completed HHS-687 on file are non-payable and may trigger compliance review. State Medicaid programs enforce this consent requirement independently of the CPT code selected.

Practices using compliance management tools can build consent tracking checkpoints into the pre-authorization and scheduling workflow, ensuring the 30-day consent window is met before the procedure date is confirmed.

NCCI Bundling Edits

The National Correct Coding Initiative (NCCI) governs which procedure pairs can be billed together and which are bundled. Before reporting 58700 alongside salpingo-oophorectomy (58720), verify the current NCCI edit table via the CMS CPT/HCPCS code list. NCCI edits are updated quarterly, and a pair that was separately billable in a prior period may be bundled in the current version. Modifier 59 or the X-modifiers (XE, XS, XP, XU) may override certain NCCI edits when the procedures are clinically distinct, but documentation must support that distinction.

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Conclusion

CPT Code 58700 is frequently miscoded because its adjacent codes cover overlapping clinical situations. The key decision points are approach (open vs laparoscopic), intent (disease process vs sterilization), and concurrent procedures (standalone vs add-on with C-section). Getting these three right eliminates the majority of 58700 denials.

Pabau’s claims management software helps OB/GYN practices build these validation rules directly into their billing workflow, flagging modifier conflicts and ICD-10 mismatches before a claim leaves the practice. To see how Pabau handles surgical billing compliance for gynecologic practices, book a demo.

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