CPT Code 58571: A Billing Guide to Laparoscopic Hysterectomy

What Is CPT Code 58571?

CPT code 58571 is the surgical code for a total laparoscopic hysterectomy on a uterus weighing 250 grams or less, performed together with removal of one or both fallopian tubes and/or ovaries. It reports the complete laparoscopic removal of the uterus and cervix plus the adnexal structures in a single code, and it is one of four codes in the 58570 to 58573 family that differ by uterine weight and whether the tubes or ovaries come out.

• Weight plus adnexa decide the code: 58571 is for a uterus 250 grams or less with tubes and/or ovaries removed. Over 250 grams, the code becomes 58573.
• Tube and ovary removal is included: The salpingo-oophorectomy is bundled into 58571, so you do not separately bill the adnexal removal on the same claim.
• Document the uterine weight: The operative and pathology reports must show the uterus weighed 250 grams or less, or the claim belongs on 58573.

What CPT 58571 Covers

CPT 58571 reports a total laparoscopic hysterectomy, meaning the surgeon removes the entire uterus and cervix through small abdominal incisions, together with removal of one or both fallopian tubes and/or ovaries. The full CPT descriptor, maintained by the American Medical Association, is laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less, with removal of tube(s) and/or ovary(s). The AMA introduced the 58570 to 58573 family in 2008 as the third set of laparoscopic hysterectomy codes, after the earlier laparoscopic-assisted and vaginal approaches.

Two facts define the code. First, the uterus must weigh 250 grams or less, since a heavier uterus moves the claim to 58573. Second, the code already includes the tube and ovary removal, so the salpingo-oophorectomy is not reported separately. Hysterectomy is one of the most common major surgeries in the country, with roughly 600,000 performed each year in the United States, and the 58570 to 58573 group is also one of the most frequently miscoded. Across the OB-GYN billing companies we vet, hysterectomy claims generate more preventable code-selection denials than almost any other surgical category.

The 58570 to 58573 Family

The whole family turns on two questions: how much did the uterus weigh, and did the tubes or ovaries come out. Answer those two correctly and the code is obvious. A surprising amount of content online flips 58571 and 58572, so it is worth anchoring to the correct matrix. Our summarized guide to the OB-GYN red book is a useful companion for keeping these code sets straight.

Code	Uterus weight	Tubes/ovaries removed
58570	250 g or less	No
58571	250 g or less	Yes
58572	Greater than 250 g	No
58573	Greater than 250 g	Yes

Total laparoscopic hysterectomy family per AMA CPT and the ACOG coding chart. The vaginal and laparoscopic-assisted approaches use different codes. The weight cutoff is not an estimate: it comes from the pathology report, and payers with access to path results will deny a 58571 claim when the specimen weighed more than 250 grams and request a corrected claim for 58573.

What Is the Difference Between 58571 and LAVH?

The difference is surgical approach, not diagnosis. CPT 58571 is a total laparoscopic hysterectomy, where the entire procedure, including detaching and removing the uterus, is done laparoscopically. A laparoscopic-assisted vaginal hysterectomy, coded 58552 for the same weight and adnexal scenario, completes part of the removal through the vagina. Payers audit that distinction closely.

The operative note has to make the approach unmistakable, because 58571 and 58552 describe different work and pay differently. The single most common coding confusion in this area is between the total laparoscopic approach and the laparoscopic-assisted vaginal approach. If the note is vague about how the uterus was detached and removed, the claim is exposed to a denial or a downcode. One question we hear constantly from OB-GYN practice managers is why two hysterectomies that looked similar in the operating room were paid differently, and the answer is almost always the documented approach.

Documentation That Prevents Denials

Because 58571 sits in a tightly audited family, the operative and pathology documentation is what stands between a clean payment and a denial. A complete 58571 record includes:

• The uterine weight from the pathology report, confirming 250 grams or less.
• The surgical approach, stated clearly as total laparoscopic, not vaginal or assisted.
• The structures removed, including the uterus, cervix, and any tubes or ovaries.
• The medical necessity, such as fibroids, abnormal bleeding, or endometriosis with failed conservative management.
• The prior authorization, which most payers require for benign indications.
• Any separately reportable procedures, distinguished from the work already bundled into 58571.

Getting these six elements into the record before the claim goes out is the difference between first-pass payment and a rework cycle.

Modifiers and Robotic Hysterectomy

A few modifiers come up regularly with 58571. Modifier 22 applies when the work is substantially greater than usual, for example dense adhesions or a difficult dissection, and it requires a note that documents the extra effort. Modifier 51 flags a distinct additional procedure performed in the same session, and modifier 62 reports two co-surgeons when each performs a distinct part of the operation. Modifiers 52 and 53 for reduced or discontinued services are rare here and demand strong documentation.

Robotic hysterectomy is a frequent source of confusion. There is no separate CPT hysterectomy code for a robotic approach. The coder selects the correct laparoscopic base code first, which for a uterus 250 grams or less with adnexal removal is 58571, then checks payer policy on whether HCPCS code S2900 should be added for the robotic assistance. Most payers fold the robotic work into the base code and do not pay S2900 separately, so verify the policy before you rely on it.

How Much Does CPT 58571 Pay in 2026?

CPT 58571 is major surgery with a 90-day global period, so the surgeon fee is a single package that covers the operation and routine follow-up for 90 days. Under the 2026 Medicare Physician Fee Schedule, the professional fee lands roughly in the high hundreds to about a thousand dollars nationally, before the separate facility fee and before locality adjustment.

Two 2026 changes matter. CMS applied a 2.5 percent efficiency adjustment that lowered the work RVUs of most non-time-based surgical codes, and it reduced the indirect practice expense allocation in the facility setting, so many gynecologic surgical payments are trending slightly lower this year. The professional fee is also only part of the picture: the hospital or ambulatory surgery center bills its own facility fee, and commercial payer rates for 58571 vary widely by contract. Because the 90-day global wraps routine post-op visits into the surgical payment, billing a separate evaluation and management visit for uncomplicated follow-up inside that window is a denial waiting to happen. Always verify the current allowable in the 2026 CMS fee schedule for your locality and your payer contracts.

Common 58571 Billing Mistakes

Most 58571 denials trace back to a short, familiar list. Providers often come to us after a batch of hysterectomy denials that all share the same two or three root causes.

• Coding the wrong weight. Billing 58571 when the pathology report shows the uterus weighed more than 250 grams, which belongs on 58573.
• Unbundling the adnexa. Separately billing the salpingo-oophorectomy that is already included in 58571.
• Confusing the approach. Reporting 58571 for a laparoscopic-assisted vaginal hysterectomy that should be 58552.
• Billing inside the global. Charging a separate evaluation and management visit for routine follow-up during the 90-day global period.
• Missing prior authorization. Submitting a benign-indication hysterectomy without the required authorization on file.
• Mishandling robotic claims. Adding S2900 where the payer folds the robotic work into the base code.

For a wider look at why these claims bounce and how to work them, see our guide to handling claim denials for your OB-GYN practice.

In-House vs Outsourced OB-GYN Billing

Whether to keep OB-GYN surgical billing in house or outsource it depends on surgical volume, payer mix, and how often hysterectomy claims are getting denied or downcoded. A small practice with light surgical volume may manage internally. A busy group doing regular laparoscopic and robotic hysterectomies, juggling prior authorizations and several payers with different bundling rules, often finds a specialized partner recovers more than the service costs by getting the code selection and documentation right the first time.

The honest test is whether your practice can say how many 58571 claims were denied or downcoded last quarter, and why. If you cannot, that blind spot is where the money leaks. In our experience matching OB-GYN practices with billing partners, the operative-note audit and a payer-by-payer bundling grid are the first things a strong partner puts in place.

Frequently Asked Questions