CPT Code for Robotic Hysterectomy: 58570–58573, LSH, LAVH and S2900 Explained

If you've searched for "the CPT code for robotic hysterectomy," you've probably noticed there isn't one. That surprises a lot of surgeons and new billers. Robotic assistance is a technique, not a separate procedure, so CPT describes what was done to the patient — a total laparoscopic hysterectomy, a supracervical hysterectomy, a laparoscopically assisted vaginal hysterectomy — rather than which instruments were used.

That makes robotic hysterectomy coding straightforward in principle and detail-heavy in practice. This guide walks through code selection, the 250-gram rule, adnexal removal, HCPCS S2900, modifiers and the documentation that keeps these high-value claims paid.

Step 1: Identify the type of hysterectomy

Robotic hysterectomies fall into the same categories as conventional laparoscopic hysterectomies. Start by answering two questions from the operative note:

1. Was the cervix removed? If yes, it's a total hysterectomy. If the uterus was amputated above the cervix, it's supracervical.
2. How was the specimen removed and the vaginal cuff handled? In a total laparoscopic hysterectomy (TLH), the entire procedure, including colpotomy, is done laparoscopically. In a laparoscopically assisted vaginal hysterectomy (LAVH), part of the procedure is completed vaginally — typically the uterine vessel ligation and removal.

Most robotic hysterectomies today are total laparoscopic hysterectomies, so 58570–58573 are the codes you'll use most.

Step 2: Apply the uterine weight threshold

Each laparoscopic hysterectomy family splits at 250 grams:

The uterine weight should come from the pathology report, not the surgeon's estimate. For that reason, we recommend holding hysterectomy claims until pathology is final. Billing 58570 and then discovering the uterus weighed 310 grams means a corrected claim at best — and lost revenue if nobody catches it.

Step 3: Account for tubes and ovaries

The "with removal of tube(s) and/or ovary(s)" codes apply whether one or both tubes and/or ovaries are removed. That has two practical consequences:

• Opportunistic salpingectomy counts. If both tubes are removed for ovarian cancer risk reduction while the ovaries are preserved, the "with tube(s)" code applies — for example 58571 instead of 58570.
• No modifier 50. Bilateral salpingo-oophorectomy doesn't take a bilateral modifier, and you shouldn't separately report 58661 for adnexal removal performed with the hysterectomy.

Step 4: Decide whether HCPCS S2900 applies

HCPCS S2900 describes "surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)." A few things to know:

• It's an S-code — a temporary national code used by some private payers. Medicare doesn't recognize S-codes.
• Payers that accept S2900 often assign it no separate payment; it's informational.
• Some payers deny the claim line, which can create noise on remits even when the primary procedure pays.

Our approach: report S2900 only for payers whose policy asks for it, and leave it off everywhere else.

Step 5: Add other procedures — carefully

Robotic hysterectomies frequently include additional work. Whether it's separately reportable depends on National Correct Coding Initiative (NCCI) edits and the documentation.

• Diagnostic laparoscopy (49320) is always included in a surgical laparoscopy.
• Lysis of adhesions (58660) is generally bundled with hysterectomy. Extensive adhesiolysis that substantially increases the work is better supported by modifier 22 on the primary procedure, with documentation of the extra time and difficulty.
• Excision or fulguration of endometriosis (58662) is commonly bundled into hysterectomy codes when performed in the same operative field. A distinct, documented site may support reporting with an appropriate modifier, but this needs careful review.
• Cystoscopy to confirm ureteral integrity is typically considered part of the hysterectomy.
• Procedures in a different anatomic area — for example an appendectomy for a separate indication — may be separately reportable.

When a bundled pair is separately reported, the claim needs modifier 59 or an X-modifier (XS, XU, XE, XP) and documentation that proves the service was distinct. Appending modifiers by default is one of the most common reasons GYN surgery claims are audited.

Step 6: Get the diagnosis right

Medical necessity is judged on the diagnosis codes, so match them to the indication and the pathology:

• D25.- — uterine leiomyoma (fibroids), by location
• N80.- — endometriosis (adenomyosis is N80.03)
• N92.- / N93.- — abnormal uterine bleeding
• N81.- — uterovaginal prolapse
• Z40.02 — prophylactic removal of ovary, and the appropriate Z15.-/Z80.- risk codes for risk-reducing surgery
• Malignancy codes when applicable — though oncologic hysterectomies often use the radical or staging codes

Many commercial and Medicaid plans also publish hysterectomy criteria for benign disease. Prior authorization should match the code you expect to bill, and if adnexal removal is added intraoperatively, the authorization may need updating within the payer's window.

Modifiers commonly used on robotic hysterectomy claims

• 22 — increased procedural services, for substantially greater work (dense adhesions, very large uterus beyond what the weight code captures, morbid obesity that substantially increases time). Requires a clear explanation in the operative note.
• 80 / 82 / AS — assistant at surgery. Check the payer's assistant-surgeon indicator for the code; many laparoscopic hysterectomy codes allow an assistant, but not all payers pay for one.
• 62 — co-surgeons, when two surgeons each perform a distinct part of the procedure (for example, a gynecologic oncologist and a colorectal surgeon).
• 59 / X-modifiers — only for distinct procedures, as described above.

Documentation checklist for robotic hysterectomy

To support accurate coding, the operative note should clearly state:

• Approach (robotic-assisted total laparoscopic, supracervical, or LAVH) and any conversion to open
• Whether the cervix was removed
• Each adnexal structure removed and laterality
• Any additional procedures, with indication and anatomic location
• Unusual findings or difficulty, with time impact, if modifier 22 may apply
• The name and role of any assistant surgeon

And the claim should wait for the pathology report with the uterine weight.

Common robotic hysterectomy coding errors

1. Billing the ≤250 g code without checking pathology
2. Billing 58570 when tubes were removed (should be 58571)
3. Reporting 58661 in addition to a "with tube(s)/ovary(s)" hysterectomy code
4. Appending modifier 50 to a bilateral salpingo-oophorectomy
5. Separately billing 49320 diagnostic laparoscopy
6. Reporting S2900 to Medicare
7. Coding an LAVH as a TLH (or vice versa) without reading the full operative description

Authorizations for robotic cases

Many payers authorize hysterectomy by CPT code, not by approach, which is helpful — robotic and conventional laparoscopic cases use the same codes. But two situations cause frequent problems:

• Weight uncertainty. If imaging suggests the uterus may be near or above 250 g, request authorization for the higher-tier code (58572/58573), or for both tiers if the payer allows. An authorization for 58570 won't always cover a 58572 billed after pathology.
• Adnexal surgery added intraoperatively. Removing the tubes changes 58570 to 58571. If the authorization didn't include adnexal removal, request an update within the payer's post-procedure window.

Some payers also apply site-of-service or medical necessity criteria to hysterectomy for benign conditions — documentation of symptoms, prior treatments and imaging findings should be in the record before surgery.

Need a second look at your GYN surgery claims?

Hysterectomy claims are among the highest-value claims an OB/GYN practice submits, which makes small coding errors expensive. Our GYN surgery coding team codes every case from the operative note and pathology report, and our coding audits can review your recent surgical claims. For a full list of related codes, see our OB/GYN CPT code library.