Tubal Ligation CPT Codes 2027: Every Approach, the New Cesarean Pairings, and ICD-10

Tubal ligation CPT codes depend on three facts: approach, technique, and timing. Laparoscopic sterilization uses 58670 for fulguration, 58671 for clips or rings, and 58661 when the tubes come out. Open or vaginal interval cases use 58600, postpartum cases during the delivery stay use 58605, and cesarean cases add +58611. Z30.2 carries the sterilization intent.

A surgeon's note that says "tubal ligation" can point to any of seven active codes. Their global periods run from none at all to 90 days, and Medicare's 2026 national payment spans about $65 to about $586. Sterilization claims also carry consent and coverage rules that other surgeries don't.

You'll find delivery, hysterectomy, and office gynecology codes in our OB/GYN CPT codes guide. This page sticks to the sterilization claim: the op note, the codes, the consent form, and the payer rules that decide whether a correct code pays.

For 2027, AMA's maternity materials announce no change to the tubal ligation codes themselves. The cesarean codes that +58611 pairs with do change on January 1, 2027, when 59502 and 59503 replace six deleted codes. Our 2027 CPT code changes guide covers the other specialties.

Tubal Ligation CPT Codes 2027 at a Glance

Seven active CPT codes cover tubal sterilization by every surgical approach, and AMA's 2027 materials announce no change to them. The table lists each code with its global period, bilateral indicator, 2026 national rate, and 2027 status. Two codes billers still run into, 58700 and 58565, close out the table.

Table 1. Tubal sterilization codes: 2026 payment data and 2027 status

Indicator 0 means the bilateral payment rule doesn't apply, so you bill one line, one unit, and no modifier 50. A 1 means you append modifier 50 and Medicare pays 150% on that single line. With a 2, the fee already covers both sides.

The dollar figures are national facility amounts: total RVUs times CMS's 2026 conversion factor of $33.4009, before local adjustment. Your MAC adjusts for locality, so your number won't match to the penny; pull the exact figure from the CMS PFS Look-Up Tool before you quote a rate to a physician.

For 2027, CMS proposed a conversion factor of $32.8409, or $33.1693 for qualifying APM participants, along with practice expense changes. Final 2027 rates arrive with the final rule, expected in early November 2026. Treat the 2026 figures as a guide until then, and see AMA's proposed rule summary for the details.

The surgeon's tubal sterilization CPT code is one line of several. Anesthesia most often bills 00851, pathology bills 88302 for the tube specimen, and every claim for the case carries Z30.2. Picking the surgeon's line comes down to three facts in the operative note.

How to Pick the Right Tubal Ligation Code

There's no single CPT code for tubal ligation. You pick the code from three facts in the operative note: the surgical approach, the technique used on the tubes, and when the surgery happened relative to a delivery. Once those three are clear, you're down to one code in most cases.

Keep one rule in mind as you read the op note, since the billing code for tubal ligation follows it: on laparoscopic cases, the technique on the tubes decides the code; on open cases, the timing decides it.

Start With the Surgical Approach

Read the approach first; it splits the codes into two main families. Laparoscopic sterilization points to 58670, 58671, or 58661. An open incision, abdominal or vaginal, points to 58600, 58605, +58611, or 58615. Hysteroscopic implants map to 58565, a legacy code, since FDA reports Essure sales ended December 31, 2018.

Mini-laparotomy sits behind most open tubal ligation CPT codes: a small incision below the navel after a delivery, or above the pubic bone for an interval case. If the surgeon converts a laparoscopic case to open, CMS's NCCI manual lets you report only the open procedure.

Match the Technique Written in the Operative Note

Laparoscopic cases turn on the technique words in the operative note. Bipolar, coagulated, cauterized, and fulgurated all point to 58670. A named device, such as a Filshie or Hulka clip, a Falope ring, or a silicone band, makes it 58671. Excised, removed, or salpingectomy means CPT 58661.

Table 2. Laparoscopic technique words and the code they point to

Table 3. Open cases: timing or device decides the code

Pomeroy, Parkland, Irving, and Uchida are ligation methods you'll see on open cases, and any of them can land on 58600, 58605, or +58611 depending on timing. A Pomeroy six weeks after delivery is 58600; the same Pomeroy the morning after a vaginal birth, before discharge, is 58605.

Patients often ask about three types of tubal ligation: tying and cutting, sealing with electric current, and blocking with a clip or ring. In coding terms, tying and cutting is an open technique in most cases (58600, 58605, or +58611), sealing is 58670, and clips or rings are 58671 (or 58615 without a scope).

Check When the Sterilization Happened

Timing sets the open code. A tubal ligation during the same hospital stay as a vaginal delivery is 58605. One done through the cesarean incision is +58611. Once the patient goes home, any later sterilization is an interval procedure, coded 58600 if open or by technique if laparoscopic.

Discharge is the dividing line. A patient who stays 4 days after a complicated birth can still have a 58605 on day 4, while a laparoscopic fulguration three weeks postpartum, after she's gone home, is 58670.

Those dates matter twice. They pick the tubal ligation CPT code, and for Medicaid patients they also decide whether the consent form, signed weeks earlier, still falls inside the required 30 to 180 days.

Laparoscopic Tubal Ligation CPT Codes: 58670 vs 58671

Most laparoscopic tubal ligation CPT code decisions come down to one question: did the surgeon seal the tubes with energy or close them with a device? Energy is 58670 and a device is 58671. If the tubes came out, neither applies; that's 58661, covered next.

What Is CPT Code 58670 Used For?

CPT 58670 reports laparoscopic sterilization in which the surgeon seals the fallopian tubes with electrosurgical energy, most often bipolar coagulation, with or without cutting them. It carries a 90-day global period, doesn't take modifier 50, and pays about $333 under Medicare's 2026 national fee schedule, before local adjustment.

AMA CPT describes 58670 as "Laparoscopy, surgical; with fulguration of oviducts (with or without transection)." Fulguration means the surgeon burns a segment of each tube closed. Coders also see it written as laparoscopic tubal fulguration or "lap cautery," and both mean 58670.

Coding note: Clips, bands, and rings are devices, so they never go to 58670. Devices are 58671.

Payer policy can add its own rules on top of CPT. Aetna's CPB 0657, Tubal Sterilization, last reviewed October 7, 2026, lists 58670, 58671, 58661, and the open codes as covered when its criteria are met. Electrocautery, clips, rings, and partial or total salpingectomy all appear as accepted methods.

When CPT 58671 Applies Instead

CPT 58671 applies when the surgeon closes the tubes with a device through the laparoscope. AMA CPT describes it as "Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring)." Filshie clips, Hulka clips, Falope rings, and silicone bands all belong here.

A note that reads "laparoscopic bilateral tubal ligation with Filshie clips" is a clean 58671. Either laparoscopic tubal sterilization CPT code carries the same 2026 numbers: 5.76 work RVUs, 9.97 total, a 090 global, and bilateral indicator 0.

Surgeons often title the case "laparoscopic BTL" whichever method they used, so code from the body of the note, where the device or energy source appears by name. A wrong pick won't change Medicare's payment, but the claim can fail an audit when the note and the code disagree.

What's Already Included in Laparoscopic Sterilization

The laparoscopic sterilization CPT code you bill already includes the diagnostic look around the pelvis. CMS's NCCI Policy Manual, Chapter VII, revised January 1, 2026, bundles diagnostic laparoscopy (49320) into surgical laparoscopy, so 49320 never goes on the claim beside 58670, 58671, or 58661. The code also covers ports, insufflation, and a uterine manipulator.

The same manual bundles lysis of adhesions. It says laparoscopic lysis (58660) "is not separately reportable with other surgical laparoscopic procedures." If dense adhesions add real time and work, document the extra minutes and the difficulty in the note, then look at modifier 22. The same logic runs through our guide to 49320 laparoscopy bundling.

Coders who pick between 58670 and 58671 from the procedure title, instead of the operative note, create errors a payer audit can catch months later. With our OB/GYN medical billing services, we start by reviewing your recent sterilization claims line by line, and billing runs at 2.99% of collections, with no setup fee and no long-term contract.

Once the note says the surgeon excised the tubes and sent them to pathology, you're coding 58661, and the 2026 payment climbs from about $333 to about $586.

CPT 58661 for Sterilization by Salpingectomy

CPT 58661 reports laparoscopic removal of adnexal structures, including partial or total salpingectomy. Since ACOG's July 2021 coding guidance, it's the code for laparoscopic sterilization when the surgeon removes the tubes instead of sealing them. CMS assigns it bilateral indicator 1, so you bill a bilateral salpingectomy as 58661-50 on one line.

The 58661 CPT code description in AMA CPT reads: "Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)." Because the same code covers ovary removal, a tubal ligation CPT code 58661 claim needs a note and a diagnosis that show sterilization intent.

Why ACOG Moved Laparoscopic Salpingectomy to 58661

ACOG changed its guidance in a July 27, 2021, coding update: "ACOG has determined that the evidence validates CPT 58661 for the removal of the fallopian tubes for sterilization laparoscopically, and not the previous recommendation, CPT 58670." Before that, ACOG's advice pointed coders to 58670.

ACOG Committee Opinion 774 (April 2019), the earlier guidance, presented salpingectomy as an option that may lower ovarian cancer risk. In August 2026, an ACOG Clinical Practice Update called complete, bilateral salpingectomy the preferred tubal approach for permanent contraception, after shared decision making.

For coders, that settles the CPT code for bilateral salpingectomy through a laparoscope for sterilization: 58661 with modifier 50. The laparoscopic bilateral salpingectomy CPT code stays 58661 for risk-reducing cases too; only the diagnosis changes.

Coding note: CPT 58700 isn't the salpingectomy code for sterilization. ACOG coding guidance says 58700 "should never be used to report a sterilization procedure of any sort." Some Medicaid programs still list it, and where a payer's written policy does, that policy governs the claim.

Does CPT 58661 Require Modifier 50?

Yes, when both tubes come out. CMS's 2026 fee schedule gives 58661 bilateral indicator 1, so modifier 50 applies and Medicare pays 150% of the fee on one line with one unit. CPT Assistant (May 2024) says the same. Some commercial payers want RT and LT lines instead, so check the policy first.

If the surgeon removes only one tube, for example because the other came out during an earlier ectopic surgery, bill 58661 with no modifier 50. Noridian's bilateral surgery guidance states the indicator 1 rule: "Use 50 modifier if bilateral. Units = 1."

A modifier that doesn't match the number of tubes removed is a common trigger for CO-4 modifier denials. The 010 global on 58661 also closes its postoperative window 80 days sooner than the 090 window on 58670, which changes how you bill a follow-up visit in week three.

What Is the Global Period for CPT 58661?

CPT 58661 carries a 10-day global period. Related follow-up care in those 10 days is part of the surgical payment, and an unrelated visit inside the window takes modifier 24. From day 11, a follow-up visit bills as its own E/M. CPT 58670 and 58671 carry 90-day globals instead.

Is 58661 Considered Sterilization?

CPT 58661 isn't a sterilization code by itself. The diagnosis and the documentation carry the intent: Z30.2 on the claim, a note that states sterilization as the goal, and, for Medicaid, a valid consent form. Without those, a payer reads 58661 as ordinary adnexal surgery and applies its usual rules.

The same surgery for another reason isn't sterilization at all. Prophylactic tube removal for ovarian cancer risk is 58661 with Z40.03 in place of Z30.2, and laparoscopic salpingectomy for an ectopic pregnancy has its own code, 59151.

Washington Medicaid draws the same line in its guide: a medically necessary salpingectomy for cancer, ectopic pregnancy, or high-risk prophylaxis "is not considered a sterilization," so no consent form applies.

On the Medicare side, Noridian's auto-deny list leaves out 58661, yet NCD 230.3 still excludes elective sterilization, so a Medicare claim for CPT 58661 sterilization with Z30.2 won't pay.

Hysterectomy With Bilateral Salpingectomy CPT Codes

Hysterectomy codes that say "with removal of tube(s)" already pay for the salpingectomy, so you don't add 58661 or 58700. Total laparoscopic hysterectomy with bilateral salpingectomy is 58571 for a uterus of 250 g or less and 58573 over 250 g. For a total abdominal hysterectomy with bilateral salpingectomy, the code is 58150.

CPT 58552 covers a laparoscopic-assisted vaginal hysterectomy, uterus 250 g or less, with removal of tubes and/or ovaries. That's the difference behind the common 58571 vs 58552 question: total laparoscopic versus laparoscopic-assisted vaginal. Anyone looking for a hysterectomy with tubal ligation CPT code gets the same answer; the tube work stays inside the hysterectomy code.

Table 4. Hysterectomy CPT codes that include tube removal

Robotic assistance doesn't change the choice, since CPT has no separate robotic hysterectomy codes. A robotic total hysterectomy with bilateral salpingectomy reports 58571 or 58573 by uterus weight. Some commercial payers also accept HCPCS S2900 for the robotic add-on, so check the contract before you add it.

Why Payers Push Back on 58661

Payers push back on 58661 because it pays more than the sterilization codes it replaced. In CMS's 2026 data, 58661 carries 11.07 work RVUs and 17.55 total, about $586, or about $879 with modifier 50. CPT 58670, laparoscopic fulguration, pays about $333, so the same sterilization can cost a payer up to 2.6 times more.

Keep Z30.2 on the claim, and if a payer questions it, send four things with the appeal:

• The operative note stating the surgeon excised the tubes
• The 88302 pathology report on the tube specimens
• ACOG's July 2021 coding guidance naming 58661
• The payer's own policy, such as Aetna's CPB 0657 listing total salpingectomy

Don't downcode to 58670 to dodge the appeal. It misreports the surgery: among tubal ligation CPT codes, 58670 describes sealed tubes that stay in the body, and an auditor comparing the claim to the pathology report will see the mismatch. Open and postpartum cases follow their own rule, since timing picks the code.

Open and Postpartum Sterilization Codes: 58600, 58605, and 58615

Among tubal ligation CPT codes, the open ones follow a different rule: timing picks the code. An interval case is 58600, a same-stay postpartum case is 58605, and a case during a cesarean is +58611. Technique matters only when a device goes in through a vaginal or suprapubic incision, which is 58615.

What Is CPT 58600?

CPT 58600 reports ligation or transection of one or both fallopian tubes through an abdominal incision, most often a mini-laparotomy, or a vaginal incision. It's an interval procedure, not part of a delivery stay, and it isn't a laparoscopic code. CMS prices it as bilateral, so it never takes modifier 50.

AMA CPT's descriptor reads "Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral." It has a 090 global and pays about $332 in 2026. If you're looking for the tubal ligation procedure code for a mini-laparotomy tubal ligation weeks after delivery, this is it.

Coding note: CPT 58600 is open or vaginal only, never laparoscopic. At a cesarean, bill +58611, not 58600 with modifier 59.

CPT 58605 After a Vaginal Delivery: Modifiers 51 and 79

CPT 58605 reports tubal ligation or transection after a vaginal delivery, during the same hospital stay. The descriptor sets no day limit; the test is the delivery admission. Append modifier 51 for the same session as the delivery and, for 2026 deliveries, modifier 79 if it happens a day or more later.

CPT describes 58605 as "Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)." It has a 090 global, bilateral indicator 2, and a 2026 rate of about $302. Modifier 51 marks a same-session second procedure.

Some payers apply multiple-procedure pricing without modifier 51, so follow their billing guide. Once the patient goes home, 58605 is off the table as the postpartum bilateral tubal ligation CPT code, and any later tubal procedure is interval work. Our guide to global surgical period rules explains how those overlapping windows interact.

The delivery codes billed with 58605 change on January 1, 2027. CPT deletes 59400, 59409, 59410, and the VBAC codes 59610 to 59614. It adds 59431 and 59432, with 59433 and 59434 for third- and fourth-degree repairs. AMA's labor FAQ says CMS designates delivery codes as 000-day globals.

Modifier 79 marks a procedure done during another procedure's postoperative period. Through 2026, it fits a 58605 done a day or more after delivery. CMS also proposed 2027 G-codes that keep the old global structure. Confirm the final rule and each payer's policy before you keep or drop 79.

CPT 58615 for Device Occlusion Without a Laparoscope

CPT 58615 reports "Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach." It carries a 010 global and bilateral indicator 0 and pays about $226 in 2026. You won't see it often; laparoscopic devices are 58671, and hysteroscopic implants are 58565.

Before you settle on 58615, confirm the note describes a small vaginal (colpotomy) or suprapubic incision and no laparoscope at any point in the case.

Postpartum Bilateral Salpingectomy After a Vaginal Delivery

Code a complete salpingectomy through a postpartum mini-laparotomy with 58605, the only postpartum sterilization code, because ACOG says 58700 "should never be used to report a sterilization procedure of any sort." Payer policy can override that. Some Medicaid programs, Washington's among them, list CPT code 58700 as a sterilization code.

Follow the payer's written policy and match it on the consent form, which should name one procedure. Washington's guide lists two consent errors that lead to denials: tubal ligation and salpingectomy listed together as the operation, and a form naming tubal ligation when the claim shows salpingectomy.

Tubal Ligation at Cesarean in 2027: +58611 With 59502 and 59503

At a cesarean, you bill the sterilization as add-on +58611 next to the cesarean code. That holds with the 2026 cesarean codes and with the new 59502 and 59503 that start January 1, 2027. A salpingectomy through the cesarean incision still points to +58611.

What Does CPT Code 58611 Represent?

CPT 58611 is an add-on code for ligating or transecting the fallopian tubes during a cesarean delivery or another intra-abdominal surgery. You never bill it alone, it takes no modifier 51, and it has no global period of its own. In 2026 it pays about $65 under Medicare's national fee schedule.

AMA CPT describes it as ligation or transection of the tubes "when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure)." One unit covers one tube or both, and bilateral indicator 0 means no modifier 50.

The primary surgery doesn't have to be a delivery. An open myomectomy (58140) with a tubal ligation through the same incision is 58140 plus +58611. It's the only add-on among tubal ligation CPT codes, and its descriptor covers intra-abdominal surgery as well as cesarean delivery.

Primary Codes for 58611 Through December 31, 2026

Through December 31, 2026, +58611 goes on the same claim as one of six cesarean codes. The right primary depends on who gave the antepartum and postpartum care and whether the patient attempted a vaginal birth after a prior cesarean. All six stay valid for dates of service in 2026.

• 59510: routine obstetric care with cesarean delivery, including antepartum and postpartum care
• 59514: cesarean delivery only
• 59515: cesarean delivery only, including postpartum care
• 59618: routine obstetric care with cesarean after an attempted vaginal delivery following a previous cesarean
• 59620: cesarean delivery only, after an attempted vaginal delivery following a previous cesarean
• 59622: cesarean delivery with postpartum care, after an attempted vaginal delivery following a previous cesarean

A repeat cesarean with bilateral tubal ligation, with the same group handling prenatal care, is 59510 plus +58611. If another group provided the prenatal care, the surgeon's claim is 59514 or 59515 plus +58611.

Primary Codes for 58611 Starting January 1, 2027

On January 1, 2027, AMA deletes 59510, 59514, 59515, 59618, 59620, and 59622. Code 59502 reports a primary cesarean, and 59503 a repeat cesarean, including one after a trial of labor. The 2027 guidelines still say: "For ligation or transection of fallopian tube[s] when done at the time of cesarean delivery, use 58611."

The date of service decides which set you use: a December 31, 2026, surgery takes the old codes, and a January 1, 2027, surgery takes the new ones.

Antepartum and postpartum visits also move to E/M codes in 2027. Our breakdown of the 2027 maternity code changes covers the full restructure, including how labor management moves to 59080 through 59083. You'll find the source text on AMA's CPT 2027 maternity changes page.

Table 5. Cesarean codes that pair with +58611, 2026 vs 2027

Repeat Cesarean With Bilateral Salpingectomy in 2027

A scheduled repeat cesarean with bilateral salpingectomy for sterilization reports 59503 and +58611 from January 1, 2027. The patient isn't in labor, so no labor management code applies. AMA's 2027 guidelines also fold same-date hospital E/M visits, 99221 to 99223 and 99231 to 99233, into a planned repeat cesarean.

A planned primary cesarean follows a different rule. With no labor, 59502 takes no labor management code, but a hospital E/M on the same date can be reported when performed. When labor comes first and ends in an unplanned cesarean, add the labor management code for that day.

Salpingectomy at Cesarean Still Reports +58611

A salpingectomy for sterilization at a cesarean still goes on the claim as +58611. ACOG rules out 58700 for any sterilization, and 58661 is a laparoscopic code that can't describe an open cesarean, which leaves +58611 as the fit. That also settles the 58611 vs 58661 question: the incision decides.

The op note should state that the tubes came out for sterilization, and Z30.2 goes on the claim after the pregnancy codes, in the order covered in the ICD-10 section below. A few Medicaid programs list 58700 among their sterilization codes, so read the policy before you appeal.

Why +58611 Pays So Little and How to Protect It

CPT 58611 pays about $65 in 2026 because it carries 1.95 total RVUs, 1.41 of them work. The cesarean code holds most of the case's value, and some payers go further, treating the ligation as part of the cesarean and paying nothing. You can answer that argument with the CPT descriptor.

Two fixes work. Negotiate separate payment for the 58611 CPT code in the contract, and appeal zero-pay lines with the descriptor, which calls it an add-on billed "in addition to code for primary procedure." You can cite AMA's 2027 cesarean guidelines too, since they send coders to 58611 by name.

Consent timing matters at a cesarean too. Medicaid's 72-hour exception covers only a premature delivery, with consent signed at least 30 days before the expected delivery date, or emergency abdominal surgery. A scheduled cesarean at term with a form signed three weeks earlier doesn't qualify, and Medicaid won't pay for the sterilization.

A payer that pays $0 on +58611 month after month has a contract gap you can raise at renewal. We flag that pattern when we review OB/GYN remittances, so you walk into the negotiation with the claim count and the dollars.

Tubal Ligation ICD-10 Codes: Z30.2, Z98.51, and Delivery Codes

Z30.2, "Encounter for sterilization," tells the payer the surgery's purpose is preventing pregnancy. For a standalone interval procedure, you list it first. On a claim that also reports the delivery, such as a cesarean with +58611, the pregnancy code goes first and Z30.2 follows.

Z30.2: The Diagnosis Behind Every Sterilization Claim

The Z30.2 diagnosis code belongs on every claim for a sterilization case: the surgeon's, the anesthesia provider's, the pathologist's, and the facility's. It's the encounter for sterilization ICD-10 code, and it stays valid in the FY2027 code set that took effect October 1, 2026.

Noridian tells Medicare billers that Z30.2 "should be noted in Item 24E of the CMS-1500 claim form or the electronic equivalent." On commercial claims, listing Z30.2 first signals the no-cost preventive benefit, and payers look for it before applying that benefit to tubal ligation CPT codes.

A request for the ICD-10 code for tubal ligation can mean either of two codes. Z30.2 reports the surgery itself, and Z98.51 reports on later visits that it already happened. Swapping them is a common sterilization ICD-10 mistake.

What Is the ICD-10 Code for Tubal Ligation With a Cesarean Section?

For a cesarean with tubal ligation, list first the Chapter 15 code for the reason the surgeon performed the cesarean, such as O34.211 for a low transverse scar from a previous cesarean. Then add Z30.2, a Z37 outcome code such as Z37.0, and the Z3A weeks code. O82 fits only cesareans with no indication.

Coding note: O82.0 doesn't exist, though it still shows up online. O82 is "Encounter for cesarean delivery without indication," and it doesn't fit most repeat cesareans. The FY 2027 ICD-10-CM guidelines put Chapter 15 codes first and call for a Z37 code on every delivery record.

What Is the ICD-10 Code for a History of Tubal Ligation?

Z98.51, "Tubal ligation status," reports a tubal ligation that happened in the past. It's a status code, so it belongs on later encounters as a secondary diagnosis and never on the sterilization claim itself. For a reversal, the encounter code is Z31.0, "Encounter for reversal of previous sterilization."

Use the tubal ligation status ICD-10 code when the history matters to the visit, such as a pelvic pain workup or a suspected ectopic pregnancy after sterilization. Leave it off visits where the sterilization history plays no part in the care.

Salpingectomy Diagnoses: Z40.03, Z30.09, and When It Isn't Sterilization

The diagnosis follows the reason for removing the tubes. Sterilization is Z30.2. Prophylactic removal is Z40.03, "Encounter for prophylactic removal of fallopian tube(s)," paired with the documented risk code, such as Z15.02 for genetic susceptibility to ovarian cancer. An ectopic pregnancy takes a code from category O00.

Coding note: Z40.02 isn't the tube code. It's "Encounter for prophylactic removal of ovary(s)." Tubes alone take Z40.03.

A pre-op counseling visit about sterilization takes Z30.09, "Encounter for other general counseling and advice on contraception." That's the ICD-10 code for a tubal ligation consult in most cases, and it keeps the counseling visit separate from the surgery's Z30.2.

The same rules apply to bilateral salpingectomy ICD-10 coding; one tube or two doesn't change the diagnosis. For ectopic cases, the FY2027 update adds O00 codes for the location of the pregnancy on October 1, 2026, so recheck any salpingectomy ICD-10 code you've built into templates.

Modifiers for Tubal Ligation CPT Codes

Most tubal ligation CPT codes never take modifier 50. The exception is 58661: CMS gives it bilateral indicator 1, so you bill a bilateral salpingectomy as 58661-50. Other modifiers depend on timing and circumstance, such as 79 or 51 on postpartum 58605, and the +58611 add-on never takes 51.

People searching for the CPT code for bilateral tubal ligation expect a modifier 50 answer. For most codes it's the opposite: 58600 and 58605 already price both sides, and 58670 and 58671 sit outside the bilateral rule. In bilateral tubal ligation CPT coding, modifier 50 belongs on 58661 alone.

Table 6. Modifiers for tubal ligation claims

Payers scrutinize XS and 59 because both override NCCI bundling edits. XS is the more specific choice: it tells the payer the second procedure happened at a separate organ or structure. Our guide to modifier 59 and XS covers when payers accept each one.

Payer Rules That Decide Whether Sterilization Claims Pay

Three payer rules decide whether a sterilization claim pays. Medicare doesn't cover elective sterilization under NCD 230.3. Medicaid pays only with a valid federal consent form signed 30 to 180 days before surgery. Most commercial plans cover sterilization without cost sharing under the ACA's women's preventive services rules.

Does Medicare Cover Tubal Ligation?

Medicare doesn't pay for sterilization when the goal is preventing pregnancy. CMS's NCD 230.3 limits payment to sterilization that's a necessary part of treating an illness or injury, such as removing diseased ovaries. Noridian's sterilization policy auto-denies six tubal sterilization CPT codes on these claims: 58600, 58605, 58611, 58615, 58670, and 58671.

Your Medicare sterilization patients are most often under 65 and qualify through disability or end-stage renal disease. Noridian's billing article A53356 says tubal ligation "in the absence of a disease for which sterilization is considered an effective treatment" isn't covered.

Settle liability before surgery. MACs frame the denial two ways: outside Medicare's benefit, which points to modifier GY, and not reasonable and necessary, which points to an ABN and modifier GA. Follow your MAC's written instruction. For dual-eligible patients, bill Medicaid as secondary after the Medicare denial, provided the consent form is valid.

Does Medicaid Pay for Tubal Ligation?

Yes, Medicaid pays for tubal ligation when you meet federal consent rules. Under 42 CFR 441.253, the patient must be at least 21 when signing and able to give informed consent, and 30 to 180 days must pass between consent and surgery. A signed HHS-687 form, or your state's approved version, goes with the claim.

The exceptions are narrow. A 72-hour minimum applies only to a premature delivery, where the patient signed at least 30 days before the expected delivery date, or to emergency abdominal surgery. Consent obtained during labor or childbirth doesn't count (42 CFR 441.257), and federal funding excludes institutionalized patients (42 CFR 441.254).

Use the current form. HHS-687, edition 07/2025 (OMB 0937-0166), expires July 31, 2028, and the Spanish version is HHS-687-1. Older editions still turn up in clinic files, so check the edition date when the patient signs.

Before surgery, check the form against this list, drawn from 42 CFR 441 and the Washington Medicaid sterilization guide:

• The patient signed at 21 or older; Washington lets patients aged 18 to 20 consent by crossing out "age 21."
• The signing day counts as day one, so surgery falls between day 31 and day 180.
• For a premature delivery, the expected delivery date appears on the form.
• If an interpreter helped, the interpreter signed Section II.
• No line is blank, and nothing changed after the patient signed.
• The sterilization date on the form matches the claim, and the form names one procedure.
• A copy goes with the surgeon's, assistant surgeon's, anesthesia, and facility claims.

Each state adds its own edits and family planning modifiers on top of the federal rules, so read your state's manual next to the regulation. Our guide to Medicaid reimbursement fixes covers the state-level problems that hold up payment. Review the tubal ligation CPT code and the consent dates together before the claim goes out.

A valid consent form won't save a claim if the surgeon isn't enrolled with the patient's Medicaid managed care plan. We handle that enrollment through credentialing at $99 per insurance, so the provider record and the claim match before the first sterilization case.

Commercial Plans: ACA Coverage and Integral Services

Most commercial plans must cover female sterilization without cost sharing. HRSA's Women's Preventive Services Guidelines include sterilization procedures, and ACA FAQs Part 54 and Part 64 extend that coverage to anesthesia, pregnancy tests, and other services "integral to the furnishing of sterilization surgeries." Grandfathered plans and some religious employers are exceptions. A federal court vacated the religious and moral exemption rules in August 2025, and the appeal is still pending, so verify each plan's status first.

The rule covers non-grandfathered plans for in-network care, and it applies to sterilization billed under the tubal ligation CPT codes and to salpingectomy done for sterilization. Aetna's CPB 0657, for example, lists total salpingectomy among its accepted sterilization methods. Put Z30.2 first and add modifier 33 if the payer asks for it.

Patients ask it as "is tubal ligation covered by insurance," and under the Affordable Care Act, often called Obamacare, most plans answer yes, with no cost sharing on the surgery or the anesthesia. If a plan applies a deductible to anesthesia or pre-op tests anyway, request reprocessing and cite ACA FAQs Part 64.

You catch the exceptions at scheduling. Grandfathered plans, employers with a religious exemption, and out-of-network surgeons can all leave the patient with a bill. Confirm the plan type and network status during benefit verification before surgery so nobody learns about a balance from the EOB.

Billing the Rest of the Claim: Anesthesia, Pathology, and Facility

A tubal ligation case produces more claims than the surgeon's. Anesthesia bills 00851, pathology bills 88302 for the tube specimen, and the facility files its own claim: CPT codes for outpatient and ASC cases, ICD-10-PCS codes for inpatient postpartum and cesarean stays. Each claim needs Z30.2.

Anesthesia: CPT 00851 and When It Doesn't Apply

CPT 00851 is "Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection," and it carries 6 base units. Use it for interval sterilization and for a postpartum tubal ligation after a vaginal delivery, which counts as its own anesthesia service.

At a cesarean, the anesthesia provider bills 01961 for the cesarean, or 01967 plus add-on 01968 when a labor epidural converts to a cesarean. There's no separate 00851 for the tubal. For 58661 done for sterilization, 00851 fits when the note documents that intent, so check the payer's anesthesia crosswalk.

Medicaid anesthesia claims need their own copy of the consent form. For base units and the anesthesia conversion factor, see the CMS Anesthesiologists Center.

Pathology: CPT 88302 for the Tube Specimen

CPT code 88302 is Level II surgical pathology, gross and microscopic examination, and CPT's specimen list for it includes "fallopian tube, sterilization." Bill one unit per specimen the surgeon submits for separate examination, so two tubes in two labeled containers are two units. The pathologist's claim needs Z30.2 too.

A few cases change the code. Tubes removed for an ectopic pregnancy fall under 88305. Clips, rings, and fulguration leave no specimen, so most 58670 and 58671 cases have no pathology line. Our guide to 88302 pathology billing covers the specimen rules in more detail.

Facility Claims and ICD-10-PCS Codes for Tubal Ligation

The setting decides the code set. Outpatient and ASC facilities report CPT codes, and hospitals report ICD-10-PCS codes for inpatient postpartum and cesarean stays. On the surgeon's claim, interval cases carry POS 24 for an ambulatory surgery center or POS 22 for on-campus outpatient, and delivery-stay cases carry POS 21.

Table 7. ICD-10-PCS codes for tubal sterilization on inpatient claims

AHA Coding Clinic, Third Quarter 2015, assigned Occlusion to ligation alone and Destruction to fulguration. A ligation followed by partial salpingectomy, such as a Pomeroy, needs a check. Coding Clinic assigned it Excision in 2015, then took the question up again in First Quarter 2018, so code it from that later issue.

If your surgeons operate in an ambulatory surgery center, our guide to POS 24 ASC claims covers the place-of-service rules that come with it.

Eight Worked Examples, Claim Line by Claim Line

The eight cases below cover common sterilization claims, from an interval salpingectomy to a 2027 cesarean. Each one shows the surgeon's CPT lines, modifiers, and diagnosis order, plus the payer detail that decides whether the claim pays. Codes follow 2026 rules unless a row says 2027.

Table 8. Worked tubal ligation claim examples, 2026 and 2027

All eight cases follow one pattern. Approach and technique set the tubal ligation CPT code, timing sets the modifier, and the payer decides whether a correct claim pays at all. Coding can't fix that third piece, so it belongs at scheduling.

Why Sterilization Claims Get Denied and How to Fix Them

Most sterilization denials trace to five issues: a consent form that fails the rules, an add-on sent without its primary, bundled services billed as extra lines, the wrong modifier 50 decision, and elective sterilization billed to Medicare. Consent errors cost the most, since nobody can repair a missed 30-day window.

January 2027 adds three risks to that list. A deleted cesarean code on a 2027 date fails the claim edit. An unplanned cesarean billed without its labor management code leaves money behind. Modifier 79 on a 58605 may no longer fit, so follow each payer's 2027 policy.

Table 9. Common denials on tubal ligation CPT codes

Four of those denial codes have their own guides. Start with CO-16 missing information for consent and data gaps. Add-on trouble, where +58611 lands without its cesarean line, has its own page under CO-234 add-on denials. For bundling, read CO-97 bundling denials. Medicare's exclusion falls under non-covered service denials.

Pre-Submission Checklist for Tubal Ligation Claims

Run every tubal ligation CPT code through the same seven checks before the claim leaves the building. The list runs in the order you'd work a case: documentation, consent, modifiers, pairing, diagnoses, payer policy, and the claims that travel with the surgeon's.

1. The operative note names the approach, the technique, and whether the tubes came out.
2. For Medicaid, the consent form falls inside 30 to 180 days, has no blanks, matches the claim dates, and travels with the claim.
3. You checked the bilateral indicator before deciding on modifier 50.
4. +58611 sits on the same claim as its cesarean code, with 2027 codes for dates of service from January 1, 2027.
5. Z30.2 is on every claim for the case, after the O codes on delivery claims.
6. You confirmed payer policy: Medicare coverage, the commercial preventive benefit, and any Medicaid FP modifier.
7. The anesthesia, pathology, and facility claims carry matching dates and diagnoses.

A sterilization denial that keeps coming back points to a step upstream, in scheduling or documentation. Our root-cause denial management team traces each repeat denial to the step that produced it and changes that step, so next month's denial report looks different.

Choosing an OB/GYN Billing Partner: What It Should Cost

An OB/GYN billing partner should track sterilization consent before surgery, code from the operative note, know each payer's sterilization policy, and handle Medicaid plan enrollment. It should also publish its pricing. MedSole RCM charges 2.99% of collections for medical billing, with no setup fee and no long-term contract, and $99 per insurance for credentialing.

For practices billing tubal ligation CPT codes every week, four checks separate a partner who protects the claim from one who only submits it:

• Consent tracked at scheduling, before the claim exists
• Coding from the operative note, including the 58661 and modifier 50 decisions
• A payer policy map, plus contract review for +58611 underpayment
• Credentialing and billing handled by the same team

Table 10. MedSole RCM billing and credentialing terms

MedSole RCM is a revenue cycle management company based in Mesa, Arizona. It charges 2.99% of collections for medical billing, with no setup fee and no long-term contract, and $99 per insurance for credentialing. The same team handles coding, denial management, AR follow-up, and prior authorization.

Tubal Ligation CPT Codes: Frequently Asked Questions

Is Tubal Ligation the Same as Bilateral Salpingectomy?

No. Tubal ligation blocks, seals, or cuts the fallopian tubes and leaves most of each tube in place. Bilateral salpingectomy removes both tubes in full. The codes differ too: laparoscopic ligation is 58670 or 58671, while laparoscopic salpingectomy is 58661 with modifier 50. At a cesarean, both go on the claim as +58611.

Clinicians and patients use several names for the same goal: tubal sterilization, bilateral tubal ligation (BTL), "tubes tied," and permanent contraception. There's no single CPT code for sterilization, so the approach and the method decide which tubal sterilization CPT code applies. For a laparoscopic removal, the bilateral salpingectomy CPT code is 58661-50.

What Is CPT Code 58661?

CPT 58661 reports laparoscopic removal of adnexal structures, meaning a partial or total oophorectomy, salpingectomy, or both. For sterilization, it's the code when the surgeon removes the tubes through the laparoscope instead of sealing them. Bill a bilateral case as 58661-50 on one line. It carries a 010 global and paid about $586 under Medicare's 2026 national fee schedule. Put Z30.2 on the claim to show sterilization intent.

How Long Is the 58661 Global Period?

CPT 58661 carries a 10-day global period. Related care during those 10 days, including routine follow-up, is part of the surgical payment. A visit for an unrelated problem inside the window takes modifier 24. From day 11, follow-up visits bill as their own E/M codes. Laparoscopic fulguration (58670) and clip or ring occlusion (58671) carry 90-day globals instead, so a week-three visit after those codes sits inside the surgical package.

What Is the CPT Code for Laparoscopic Bilateral Salpingectomy?

Report 58661 with modifier 50 for a laparoscopic bilateral salpingectomy. CMS gives 58661 bilateral indicator 1, so Medicare pays 150% on one line with one unit. Some commercial payers want RT and LT lines instead, so check the policy. For sterilization, add Z30.2 and, for Medicaid, a valid consent form. For risk reduction, use Z40.03 with the risk code. A salpingectomy at cesarean is +58611, not 58661.

What Is the CPT Code for Total Laparoscopic Hysterectomy with Bilateral Salpingectomy?

Report 58571 when the uterus weighs 250 g or less and 58573 when it weighs more. Both codes include removal of the tubes, the ovaries, or both, so you don't add 58661 or 58700. A total abdominal hysterectomy with bilateral salpingectomy is 58150. A laparoscopic-assisted vaginal hysterectomy with tube removal is 58552 or 58554. Robotic assistance doesn't change the CPT code.

What Is CPT Code 58611?

CPT 58611 is the add-on code for ligation or transection of the fallopian tubes at a cesarean delivery or other intra-abdominal surgery. You never bill it alone, and it takes no modifier 51 and has no global period of its own. In 2026 it pairs with codes such as 59510 or 59514. From January 1, 2027, it pairs with 59502, 59503, or 59504. Medicare's 2026 national rate is about $65.

Can You Get Your Tubes Tied During a C-Section, and How Is It Billed?

Yes. A tubal ligation or salpingectomy through the cesarean incision goes on the claim as add-on +58611, next to the cesarean code. Medicaid patients must sign the consent form at least 30 days before surgery, because the 72-hour exception covers only premature delivery or emergency abdominal surgery.

Through December 31, 2026, the cesarean code is 59510, 59514, or another code in that family; from January 1, 2027, it's 59502 or 59503. +58611 pays about $65 under Medicare's 2026 national fee schedule, and the tubal ligation CPT code stays the same whether the surgeon ties the tubes or removes them.

What Is the CPT Code for a Repeat Cesarean with Bilateral Salpingectomy in 2027?

From January 1, 2027, report 59503 for the repeat cesarean and +58611 for the bilateral salpingectomy through the cesarean incision. A scheduled repeat cesarean without labor takes no labor management code. AMA also includes same-date hospital E/M visits in 59503. In 2026, the same case is 59510, 59514, or 59515 plus +58611. Code Z30.2 after the pregnancy codes, and file the Medicaid consent form.

What Is the Postpartum Tubal Ligation CPT Code?

Report 58605 for a tubal ligation or transection after a vaginal delivery, during the same hospital stay. The descriptor covers an abdominal or vaginal approach on one or both tubes. Add modifier 51 when it happens in the same session as the delivery. For 2026 deliveries, add modifier 79 when it happens a day or more later. After discharge, the procedure becomes interval work, coded 58600 or a laparoscopic code.

What Is the CPT Code for a Mini-Laparotomy Tubal Ligation?

The answer depends on timing. An interval tubal ligation through a mini-laparotomy is 58600. A ligation or transection through a mini-laparotomy during the delivery stay after a vaginal birth is 58605. A ligation through the cesarean incision is +58611. When a clip or Falope ring goes in through a small suprapubic or vaginal incision without a laparoscope, report 58615. Code the technique from the body of the operative note.

What Is the CPT Code for a Laparoscopic Tubal Ligation with Falope Rings?

Report 58671, laparoscopic occlusion of the oviducts by device. Falope rings, Filshie clips, Hulka clips, and silicone bands all fall under 58671. Don't add modifier 50, since CMS gives 58671 bilateral indicator 0 and one unit covers both tubes. Add Z30.2 as the diagnosis. A hospital reporting the case on an inpatient claim uses ICD-10-PCS 0UL74CZ. Rings leave no specimen, so there's no pathology line.

What Is the ICD-10 Code for Tubal Ligation?

Use Z30.2, encounter for sterilization, for the tubal ligation itself. It goes on the surgeon's, anesthesia, pathology, and facility claims for the case. For an interval procedure, list it first. At a cesarean, list the pregnancy codes first, then Z30.2, Z37, and Z3A. On later visits, a past tubal ligation is Z98.51. Both codes stay valid in the FY2027 code set.

What Is the ICD-10 Code for a History of Tubal Ligation?

Report Z98.51, tubal ligation status, when a past tubal ligation matters to the visit. A pelvic pain workup or a suspected ectopic pregnancy after sterilization are common examples. It's a status code, so it goes on later encounters as a secondary diagnosis, never on the sterilization claim. A visit for reversal uses Z31.0 instead. Z98.51 stays valid in the FY2027 ICD-10-CM code set.

What Is the Anesthesia Code for a Tubal Ligation?

Report 00851, anesthesia for intraperitoneal procedures in the lower abdomen including laparoscopy, tubal ligation or transection. It carries 6 base units. It fits interval cases and a postpartum tubal ligation after a vaginal delivery. At a cesarean, the anesthesia provider bills 01961, or 01967 plus 01968 after a labor epidural, with no separate line for the tubal. Medicaid anesthesia claims need a consent copy too.

What Is the ICD-10-PCS Code for a Laparoscopic Tubal Ligation by Electrocautery?

AHA Coding Clinic, Third Quarter 2015, assigns the root operation Destruction to fulguration of the fallopian tubes. A bilateral laparoscopic tubal ligation by electrocautery codes to 0U574ZZ, Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach. Clips or rings code to Occlusion, 0UL74CZ. For a ligation with an excised segment, check Coding Clinic First Quarter 2018. ICD-10-PCS applies to hospital inpatient claims, and the surgeon still reports CPT 58670.

Does Insurance Cover Tubal Ligation?

In most cases, yes. Non-grandfathered commercial plans cover female sterilization without cost sharing under the ACA, and Medicaid covers it when the consent paperwork meets federal rules. Medicare is the exception: it doesn't cover sterilization done only to prevent pregnancy. Coverage for salpingectomy, anesthesia, and facility fees still needs checking.

The same CPT code for tubal ligation can pay under one plan and deny under another, so your front desk should verify benefits at scheduling. Patients who ask whether Medicaid covers getting their tubes tied should hear yes, along with the consent timing, at the first visit.

Which Tubal Ligation CPT Codes Change in 2027?

AMA's 2027 maternity materials announce no change to 58600, 58605, 58611, 58615, 58661, 58670, or 58671, so confirm them in the CPT 2027 codebook. The cesarean codes that +58611 pairs with do change on January 1, 2027. 59502 and 59503 replace six deleted cesarean codes, and 59504 replaces 59525.

CPT 58565, the hysteroscopic implant code, is still active, but FDA's Essure page notes that US sales ended December 31, 2018. For 2027, AMA's labor FAQ says CMS designates delivery codes as 000-day globals. Check the final rule and payer policy before you add modifier 79 to 58605.

How Do You Get Tubal Ligation Reversal Covered by Insurance?

It's hard, because most plans treat reversal as elective. You bill reversal with 58750 for an open tubotubal anastomosis or unlisted code 58679 for a laparoscopic repair, with diagnosis Z31.0. Ask for a written benefit and prior authorization decision before scheduling, since many plans exclude it.

Z98.51 documents the earlier sterilization on related visits. Coders searching for a tubal reanastomosis CPT code most often mean 58750; reanastomosis and tubotubal anastomosis describe the same repair. If the plan denies coverage in writing, the patient can make an informed choice about self-pay before the surgery date.

What Happens If the Sterilization Is Delayed Past 180 Days?

The consent expires. Under 42 CFR 441.253, federal Medicaid funding requires that no more than 180 days pass between consent and surgery, so a case that slips past day 180 needs a new HHS-687 and a new 30-day wait. Medicaid won't pay on the old form, however complete it is.

Delivery dates move and surgeons reschedule, so track the day-180 date at scheduling the same way you track day 31. Washington's guide, for example, counts the signing day as day one and allows surgery from day 31 through day 180, and no corrected claim can rescue a missed window.

What Should an OB/GYN Practice Pay for Billing and Credentialing?

MedSole RCM charges 2.99% of collections for medical billing, with no setup fee and no long-term contract. Credentialing costs $99 per insurance, handled by the same team that bills the claims. A free billing analysis shows what your practice would pay, and we reply within one business day.

That rate should cover coding, denial management, and AR follow-up along with claim submission. For OB/GYN work, it should also include consent tracking before sterilization cases and a review of payer contracts that underpay +58611.

Is There a Tubal Ligation CPT Codes Cheat Sheet PDF?

Yes. The 2027 glance table near the top of this guide lists every tubal ligation code with its global period, bilateral indicator, and 2026 rate. MedSole RCM also sends a printable 2027 tubal ligation CPT codes PDF with a free billing analysis of your sterilization claims. We reply within one business day. Use the table until the PDF arrives.

Tubal Ligation CPT Codes in 2027: The Bottom Line

Approach and technique pick the laparoscopic code, and timing picks the open one. CPT 58661 takes modifier 50, and +58611 pairs with 59502, 59503, or 59504 from January 1, 2027. Payer rules, from Medicare's exclusion to Medicaid consent and commercial preventive coverage, decide whether correct tubal ligation CPT codes turn into payment.

Our outsourced OB/GYN billing team codes from the op note, tracks consent before surgery, and follows each payer's rules. Billing runs 2.99% of collections with no setup fee and no long-term contract, and credentialing runs $99 per insurance. Start with a free billing analysis, and we reply within one business day.