If you’ve spent any time in gynecologic surgical billing, you know the 58570–58573 code family is one of those areas where a single wrong digit costs you a claim or worse, triggers a compliance audit. CPT code 58571 is the one that trips up billing teams most often, because it sits right at the intersection of uterine weight, adnexal removal, and laparoscopic technique. Get any one of those three elements wrong in your documentation or code selection, and you’re looking at a denial, a downcode, or a takeBack.
This guide covers everything the official description, how 58571 relates to its sibling codes, Medicare coverage rules, cost benchmarks, the global period, and modifier use written for people who actually work with these claims.
What CPT Code 58571 Actually Describes
The official CPT description is: Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 grams; with removal of tube(s) and/or ovary(s).
In plain terms: it’s a completely laparoscopic total hysterectomy performed on a patient whose uterus weighs more than 250 grams, during which the surgeon also removes at least one fallopian tube and/or at least one ovary. All three elements have to be present laparoscopic approach, uterine weight threshold, and adnexal removal before this code is appropriate.
The 250-gram cutoff matters clinically, not just administratively. A uterus that heavy usually indicates significant pathology most commonly large fibroids (leiomyomas) or diffuse adenomyosis. These cases involve more operative time, more technical difficulty, and more risk than a straightforward hysterectomy on a normal-sized uterus, which is exactly why the code family splits at that weight.
The 58570–58573 Code Family How They Differ
You cannot use 58571 correctly without understanding where it sits in the family. These four codes are separated by just two variables: uterine weight and whether the adnexa were removed.
CPT code 58570 laparoscopic total hysterectomy, uterus 250 grams or less, no adnexal removal. This is the baseline code lowest complexity, lowest RVU weight, most straightforward documentation requirements.
CPT code 58571 laparoscopic total hysterectomy, uterus greater than 250 grams, with removal of tube(s) and/or ovary(s). The heavier uterus and adnexal work together push this into a higher-complexity tier.
58572 CPT code laparoscopic total hysterectomy, uterus greater than 250 grams, but without adnexal removal. Same weight threshold as 58571, but the tubes and ovaries stay in. This is the one most often mixed up with 58571 the only difference is whether the adnexa came out.
CPT code 58573 laparoscopic total hysterectomy, uterus greater than 250 grams, with adnexal removal, plus radical resection of pelvic lymph nodes and/or para-aortic lymph nodes. This is a fundamentally different procedure reserved for oncologic cases. If you’re seeing this code billed in a general gynecology practice, that’s a red flag worth investigating.
The practical takeaway: if the uterus weighed more than 250 grams and the surgeon took out at least one tube or ovary but did not do a lymphadenectomy, the code is 58571. Full stop.
CPT 58571 vs 58573 The Distinction That Matters Most for Compliance
This comparison comes up constantly in audits and is one of the most searched billing questions for this code family. On the surface, both codes look similar heavy uterus, laparoscopic approach, adnexal removal. But the difference between them is not subtle.
CPT 58573 includes a radical lymphadenectomy the surgical removal of pelvic and/or para-aortic lymph nodes which is a completely separate and substantial surgical undertaking typically performed in cases of suspected or confirmed endometrial or cervical cancer. It doesn’t belong in a routine fibroid hysterectomy claim.
Billing 58573 when only the work described by 58571 was performed is upcoding, and it is specifically the type of discrepancy that Medicare RAC auditors and OIG compliance reviews are designed to catch. The operative note must explicitly document lymph node dissection not just mention lymph nodes were observed or not removed before 58573 can be supported.
If your documentation says anything like “tubes and ovaries removed, uterus sent to pathology, patient tolerated procedure well,” that’s a 58571. It is not a 58573.
Medicare Coverage What Gets Paid and What Doesn’t
Medicare covers CPT 58571 under the Physician Fee Schedule when the procedure is medically necessary and properly documented. Coverage is governed by Local Coverage Determinations (LCDs) issued by the Medicare Administrative Contractor (MAC) for your geographic region, so the specific requirements vary somewhat depending on where your practice is located.
The diagnoses that most commonly support medical necessity for 58571 include:
Uterine leiomyomas (D25.x): fibroids are the most common indication. Documentation should confirm the symptom burden heavy menstrual bleeding, pelvic pressure, bulk symptoms and should reflect that conservative management was either attempted and failed or was medically contraindicated or declined by the patient.
Adenomyosis (N80.0): Diffuse or focal adenomyosis with severe dysmenorrhea or menorrhagia that has not responded to hormonal therapy or other medical management.
Abnormal uterine bleeding (N93.8): Requires documentation of the diagnostic work-up, relevant pathology results, and the reasoning behind surgical management over continued medical therapy.
Uterine prolapse (N81.x): When prolapse repair is combined with removal of the adnexa due to concurrent pathology, 58571 may be appropriate.
One documentation requirement that billing teams sometimes overlook the pathology report must confirm uterine weight exceeding 250 grams. Surgeon estimates or OR notes that say “large fibroid uterus” are not sufficient for many payers. If the pathology report comes back and the uterus weighed 235 grams, the correct code is 58570 or 58572, not 58571 regardless of what was estimated intraoperatively.
CPT Code 58571 Cost: What Medicare Pays
The reimbursement for 58571 depends on the setting, geographic adjustment, and whether you’re calculating the facility or non-facility rate.
For 2025, the approximate Medicare national payment rates for the professional component of CPT 58571 are:
Non-facility setting: roughly $1,380–$1,450
Facility setting (hospital/ASC): roughly $840–$910
Work RVUs: approximately 21.7
These are physician professional fees only. The hospital or ASC bills facility charges separately under their own payment systems. When you factor in anesthesia, facility fees, and any ancillary services, the total claim for a 58571 surgery commonly runs between $10,000 and $20,000 or more, depending on the region and payer.
Commercial insurers generally pay above Medicare rates often 120 to 150 percent of the Medicare allowable but this varies significantly by contract. Always verify the payer-specific fee schedule before estimating patient responsibility.
The CPT 58571 Global Period 90 Days and What It Means
CPT 58571 carries a 90-day global surgical period, which classifies it as a major surgery under Medicare’s global surgery rules. Understanding what this means in practice is critical to avoiding post-surgical billing errors.
Within that 90-day window, the surgeon’s global fee is considered to bundle:
One pre-operative day immediately before surgery
The surgical procedure itself
All routine post-operative evaluation and management for 90 days following the procedure date
This means that when a patient returns for her two-week post-op visit, her six-week check-in, or any other routine surgical follow-up within 90 days, the operating surgeon cannot bill a separate E&M code for those encounters. The global fee has already been paid to cover them.
Where practices get into trouble is billing post-op E&M visits out of habit or because the patient was seen by a different provider in the same group. The surgeon’s group cannot separately bill routine post-op care for 58571 within the global period, regardless of which provider in the practice sees the patient.
Exceptions that do allow separate billing within the global period:
When a patient develops a new, unrelated medical condition during recovery a urinary tract infection, a cardiac issue, an orthopedic problem the E&M for that unrelated visit can be billed separately using modifier -24 appended to the E&M code. The medical record must clearly document that the visit was for a condition unrelated to the hysterectomy.
If the patient requires a return to the operating room for a complication related to the original procedure, modifier -78 allows billing for the additional surgery during the global period.
If the operating surgeon transfers post-operative care to another provider, modifiers -54 and -55 split the global period between the surgical provider and the receiving provider proportionally.
CPT 58571 Modifiers: When and Why to Use Them
Modifiers are where a significant amount of money is left on the table or lost to denials. Here are the modifiers most commonly applicable to 58571 claims:
Modifier -22 is for increased procedural services. Use this when the operative note documents that the case required significantly more work than a typical 58571 dense pelvic adhesions from prior surgeries, severe endometriosis, morbid obesity, or a particularly difficult anatomic presentation. You must attach written documentation explaining the increased complexity. Without a supporting letter, most payers will ignore the modifier.
Modifier -51 applies when multiple procedures are performed during the same operative session. The secondary procedure is typically reimbursed at 50 percent of its base rate. Make sure your billing system isn’t auto-appending -51 to 58571 if it is the primary procedure.
Modifier -62 is for co-surgery when two surgeons of equal standing are required to perform the procedure together. Each surgeon bills 58571 with -62. This is appropriate in complex cases where, for example, a gynecologic surgeon and a urologist are both primary operating surgeons.
Modifier -80 is for an assistant surgeon. If a second surgeon assists (not co-operates) on a 58571, they bill 58571 with -80 and are reimbursed at approximately 16 percent of the primary allowable.
Modifier -54 (surgical care only) and -55 (post-operative management only) are used when the operating surgeon and the managing physician are splitting the global period, as discussed above.
The Most Common Billing Mistakes for CPT 58571
Coding before pathology is available some practices code from the OR note alone because the pathology report takes days. This is risky if the uterine weight comes back under 250 grams. Build a workflow that holds the final code selection until pathology is in hand.
Using 58571 when 58572 is correct if the surgeon didn’t remove any tubes or ovaries, the code is 58572. This is the most common code selection error in the family and it usually goes in the wrong direction 58571 reimbursed higher, so there’s pressure to use it, but without documented adnexal removal it won’t hold up.
Billing E&M during the global period routine post-op visits are not separately billable. If your practice sees a high volume of gynecologic surgery, consider a dedicated audit of post-op E&M billing against surgical global period dates.
Skipping modifier -22 on genuinely complex cases surgeons document difficult cases extensively in operative notes but nobody flags the account for a modifier -22 review. Create a trigger any note that uses phrases like “extensive adhesiolysis,” “severe adhesive disease,” or “conversion risk” should automatically route for modifier review.
Not verifying the MAC’s LCD before submitting medicare LCDs for hysterectomy coding differ by region. Some MACs have explicit documentation checklists. Submitting without checking those requirements is billing on hope, not knowledge.
Quick Reference: Which Code to Use
| Situation | Correct Code |
|---|---|
| Laparoscopic hysterectomy, uterus ≤ 250g, no adnexal removal | 58570 |
| Laparoscopic hysterectomy, uterus > 250g, with tube(s)/ovary(s) removed | 58571 |
| Laparoscopic hysterectomy, uterus > 250g, no adnexal removal | 58572 |
| Laparoscopic hysterectomy, uterus > 250g, adnexal removal, plus lymphadenectomy | 58573 |
Final Thought
CPT 58571 is not a complicated code to understand but it is easy to misuse, because the right answer depends on clinical facts that don’t always make it cleanly from the OR to the billing team. Uterine weight confirmed by pathology. Adnexal removal documented in the operative report. Global period tracked in your PM system. Modifiers applied when the clinical record supports them. Get those four things right consistently, and 58571 claims clear without drama. Miss any one of them, and you’re spending time on appeals, refunds, or audit responses none of which is a good use of anyone’s day.
Make An Appintment With UsFAQs
CPT 58552 describes a laparoscopic-assisted vaginal hysterectomy (LAVH) for a uterus over 250 grams with removal of tubes and/or ovaries meaning part of the procedure is completed vaginally. CPT 58571, by contrast, is a totally laparoscopic hysterectomy with no vaginal surgical component. The key distinction is the surgical approach: assisted vaginal completion versus entirely laparoscopic completion.
CPT 58571 is used to report a total laparoscopic hysterectomy performed on a uterus weighing more than 250 grams, with removal of one or both fallopian tubes and/or ovaries. It is most commonly indicated for large uterine fibroids, adenomyosis, or significant abnormal uterine bleeding where the uterus has grown beyond the standard weight threshold and adnexal removal is clinically warranted.
CPT 58571 can be performed in either an inpatient hospital, outpatient hospital, or ambulatory surgical center (ASC) setting depending on the patient's clinical condition and the surgeon's judgment. Medicare and most commercial payers recognize it in all three settings, though the reimbursement rate differs by place of service. Straightforward cases in healthy patients are increasingly performed in the outpatient or ASC setting.
Both codes describe a total laparoscopic hysterectomy, but they differ on two points: uterine weight and adnexal removal. CPT 58570 applies when the uterus weighs 250 grams or less and no tubes or ovaries are removed. CPT 58571 applies when the uterus exceeds 250 grams and at least one tube and/or ovary is also removed making it the higher-complexity code of the two.