CPT® Code 58146

Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach

Myomectomy is a surgical procedure aimed at the excision of fibroid tumors from the uterus. Uterine fibroids, also known as leiomyomas, are benign tumors that develop from the muscle tissue of the uterus, specifically the myometrium. These tumors can vary in location and type, including submucous, intramural, subserous, and pedunculated fibroids. Submucous fibroids extend into the uterine cavity and are typically addressed through hysteroscopic techniques. Intramural fibroids are embedded within the uterine muscle, while subserous fibroids are located on the outer surface of the uterus and may be attached by a thin stalk, known as pedunculation. The procedure described by CPT® Code 58146 specifically refers to the abdominal approach for the removal of five or more intramural myomas or for myomas that collectively weigh more than 250 grams. During this procedure, an incision is made in the abdomen to access the uterus, which is then inspected and palpated to locate the fibroids. If the fibroids are intramural, the surgeon incises the uterus to reach the fibroid, which is then carefully removed from the uterine wall. The use of electrocautery helps control any bleeding during the excision. After the fibroids are removed, the uterus is sutured back together in layers to ensure proper healing. This procedure is essential for patients experiencing significant symptoms due to the presence of multiple fibroids, such as heavy menstrual bleeding, pelvic pain, or pressure symptoms, and aims to alleviate these issues while preserving the uterus.