CPT® Code 58290

The CPT® Code 58290 refers to a vaginal hysterectomy performed specifically for the removal of an enlarged uterus weighing greater than 250 grams. This surgical procedure is often necessary when the uterus has become significantly enlarged, which can occur due to various conditions such as fibroids or other abnormalities. The removal of such a large uterus may require the use of morcellation techniques, which involve breaking the uterus into smaller pieces to facilitate its extraction through the vaginal canal. This is particularly important in cases where the size of the uterus makes it impractical to remove it in one piece. The procedure typically involves several steps, including the placement of tenacula on the cervix to provide traction, incising the vaginal mucosa around the cervix, and carefully separating the bladder from the uterus. The surgical team will employ various dissection techniques to expose and ligate the uterine vessels, ensuring that the uterus can be safely removed. The procedure concludes with the closure of the peritoneum and leaving the vaginal cuff open for drainage, which is a critical aspect of post-operative care. This code is specifically utilized when only the uterus is removed, distinguishing it from other related codes that involve the removal of additional structures such as the fallopian tubes and ovaries.