Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 1 of 8
Type of
Oophorectomy Procedure
Code Code
Type* Description
Unspecified 4690 Berkson Abdominal hysterectomy with salpingo-oophorectomy 4695 Berkson Subtotal hysterectomy with salpingo-oophorectomy
4700† Berkson Vaginal hysterectomy with or without salpingo-oophorectomy 4710† Berkson Vaginal hysterectomy with plastic repair for multiple relaxed pelvic conditions with or without salpingo-oophorectomy 4720† Berkson Wertheim hysterectomy
4830 Berkson Oophorectomy
4870 Berkson Salpingo-oophorectomy
45126 CPT-4
Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and
ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof
56307 CPT-4 Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
56308 CPT-4 Laparoscopy, surgical; with vaginal hysterectomy with or without removal of tube(s), with or without removal of ovary(s)
(laparoscopic assisted vaginal hysterectomy)
57531 CPT-4
Radical trachelectomy, with bilateral total pelvic
lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)
58150 CPT-4 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
58152 CPT-4
Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch)
58180 CPT-4 Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)
58200 CPT-4 Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)
58210 CPT-4
Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 2 of 8
Appendix 1. Continued Type of
Oophorectomy Procedure
Code Code
Type* Description
Unspecified 58240 CPT-4
Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or
abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
58262 CPT-4 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)
58263 CPT-4 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele
58291 CPT-4 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
58292 CPT-4 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele 58542 CPT-4 Laparoscopy, surgical, supracervical hysterectomy, for uterus
250 g or less; with removal of tube(s) and/or ovary(s)
58544 CPT-4 Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
58571 CPT-4
Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed
58573 CPT-4 Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
58661 CPT-4 Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) 58720 CPT-4 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g
or less; with removal of tube(s) and/or ovary(s)
58940 CPT-4 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) 58943 CPT-4 Laparoscopy, surgical; with removal of adnexal structures (partial
or total oophorectomy and/or salpingectomy)
58950 CPT-4 Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
58951 CPT-4 Oophorectomy, partial or total, unilateral or bilateral;
58952 CPT-4
Oophorectomy, partial or total, unilateral or bilateral; for
ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without
salpingectomy(s), with or without omentectomy
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 3 of 8
Oophorectomy Code Type
Unspecified 58953 CPT-4 Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;
58954 CPT-4
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and
omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy
58956 CPT-4
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and
omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)
58957 CPT-4 Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;
58958 CPT-4
Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;
with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
59120 CPT-4 Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy
59125 CPT-4 Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed;
59151 CPT-4
Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; with pelvic
lymphadenectomy and limited para-aortic lymphadenectomy Unilateral 65.31 ICD-9 Laparoscopic unilateral oophorectomy
65.39 ICD-9 Other unilateral oophorectomy
65.41 ICD-9 Laparoscopic unilateral salpingo-oophorectomy 65.49 ICD-9 Other unilateral salpingo-oophorectomy 0UT00ZZ ICD-10 Resection of right ovary, open approach
0UT04ZZ ICD-10 Resection of right ovary, percutaneous endoscopic approach 0UT07ZZ ICD-10 Resection of right ovary, via natural or artificial opening 0UT08ZZ ICD-10 Resection of right ovary, via natural or artificial opening
endoscopic
0UT0FZZ ICD-10 Resection of right ovary, via natural or artificial opening with percutaneous endoscopic assistance
0UT10ZZ ICD-10 Resection of left ovary, open approach
0UT14ZZ ICD-10 Resection of left ovary, percutaneous endoscopic approach 0UT17ZZ ICD-10 Resection of left ovary, via natural or artificial opening
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 4 of 8
Appendix 1. Continued Type of
Oophorectomy Procedure
Code Code
Type* Description
Unilateral 0UT18ZZ ICD-10 Resection of left ovary, via natural or artificial opening endoscopic
0UT1FZZ ICD-10 Resection of left ovary, via natural or artificial opening with percutaneous endoscopic assistance
Bilateral 65.51 ICD-9 Other removal of both ovaries at same operative episode 65.52 ICD-9 Other removal of remaining ovary
65.53 ICD-9 Laparoscopic removal of both ovaries at same operative episode 65.54 ICD-9 Laparoscopic removal of remaining ovary
65.61 ICD-9 Other removal of both ovaries and tubes at same operative episode
65.62 ICD-9 Other removal of remaining ovary and tube
65.63 ICD-9 Laparoscopic removal of both ovaries and tubes at same operative episode
65.64 ICD-9 Laparoscopic removal of remaining ovary and tube 0UT20ZZ ICD-10 Resection of bilateral ovaries, open approach
0UT24ZZ ICD-10 Resection of bilateral ovaries, percutaneous endoscopic approach
0UT27ZZ ICD-10 Resection of bilateral ovaries, via natural or artificial opening 0UT28ZZ ICD-10 Resection of bilateral ovaries, via natural or artificial opening
endoscopic
0UT2FZZ ICD-10 Resection of bilateral ovaries, via natural or artificial opening with percutaneous endoscopic assistance
CPT, Current Procedural Terminology; ICD, International Classification of Diseases; REP, Rochester Epidemiology Project.
* Berkson codes (specific to REP providers) were used between 1/1/1950 and 12/31/1986, ICD-9 codes were used between 1/1/1987 and 9/30/2015, and ICD-10 codes were used starting on 10/1/2015. In addition, we included non-specific CPT-4 codes starting on 1/1/1987 that were used for outpatient or same-day procedures that were not captured by ICD codes.
† Limited to women who also had a separate anatomical code for ovary/fallopian tube.
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 5 of 8
Calendar Year and
Age Groups Person-Years
Unilateral Bilateral
N
Incidence (95% CI)* (per 100,000 person-years)
N
Incidence (95% CI)* (per 100,000 person-years)
1950-1954† 62,777 95 166 (132-199) 74 140 (108-172)
18-24 y 17,202 6 35 (13-76) 2 12 (1-42)
25-29 y 10,659 9 84 (39-160) 1 9 (0-52)
30-34 y 9,673 17 176 (102-281) 7 72 (29-149)
35-39 y 9,019 21 233 (144-356) 12 133 (69-232)
40-44 y 8,288 23 278 (176-416) 23 278 (176-416)
45-49 y 7,936 19 239 (144-374) 29 365 (245-525)
1955-1959† 68,558 99 166 (133-199) 54 94 (68-119)
18-24 y 19,389 6 31 (11-67) 0 0 (0-0)
25-29 y 11,375 10 88 (42-162) 2 18 (2-64)
30-34 y 10,594 8 76 (33-149) 5 47 (15-110)
35-39 y 9,763 21 215 (133-329) 12 123 (64-215)
40-44 y 8,838 22 249 (156-377) 17 192 (112-308)
45-49 y 8,599 32 372 (255-525) 18 209 (124-331)
1960-1964† 76,989 148 213 (178-248) 57 95 (70-120)
18-24 y 22,717 16 70 (40-114) 0 0 (0-0)
25-29 y 13,155 18 137 (81-216) 1 8 (0-42)
30-34 y 11,927 24 201 (129-299) 1 8 (0-47)
35-39 y 10,448 30 287 (194-410) 12 115 (59-201)
40-44 y 9,507 34 358 (248-500) 17 179 (104-286)
45-49 y 9,235 26 282 (184-413) 26 282 (184-413)
1965-1969† 89,407 160 205 (172-238) 99 152 (122-182)
18-24 y 27,751 23 83 (53-124) 1 4 (0-20)
25-29 y 16,539 16 97 (55-157) 2 12 (1-44)
30-34 y 13,884 27 194 (128-283) 6 43 (16-94)
35-39 y 11,047 28 253 (168-366) 10 91 (43-166)
40-44 y 10,355 41 396 (284-537) 39 377 (268-515)
45-49 y 9,831 25 254 (165-375) 41 417 (299-566)
1970-1974† 101,522 216 238 (205-270) 201 273 (234-312)
18-24 y 32,075 30 94 (63-134) 6 19 (7-41)
25-29 y 19,488 31 159 (108-226) 9 46 (21-88)
30-34 y 15,960 43 269 (195-363) 23 144 (91-216)
35-39 y 12,342 52 421 (315-553) 29 235 (157-337)
40-44 y 11,378 35 308 (214-428) 57 501 (379-649)
45-49 y 10,279 25 243 (157-359) 77 749 (591-936)
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 6 of 8
Appendix 2. Continued
Calendar Year and
Age Groups Person-Years
Unilateral Bilateral
N
Incidence (95% CI)* (per 100,000 person-years)
N
Incidence (95% CI)* (per 100,000 person-years)
1975-1979† 113,207 225 222 (192-252) 143 182 (151-212)
18-24 y 35,331 25 71 (46-104) 5 14 (5-33)
25-29 y 21,789 29 133 (89-191) 4 18 (5-47)
30-34 y 18,217 49 269 (199-356) 17 93 (54-149)
35-39 y 14,695 57 388 (294-503) 20 136 (83-210)
40-44 y 12,672 44 347 (252-466) 40 316 (226-430)
45-49 y 10,503 21 200 (124-306) 57 543 (411-703)
1980-1984† 123,648 170 155 (131-179) 148 176 (147-205)
18-24 y 34,967 18 51 (31-81) 1 3 (0-16)
25-29 y 23,843 22 92 (58-140) 3 13 (3-37)
30-34 y 21,250 29 136 (91-196) 14 66 (36-111)
35-39 y 17,402 35 201 (140-280) 21 121 (75-184)
40-44 y 14,543 44 303 (220-406) 35 241 (168-335)
45-49 y 11,643 22 189 (118-286) 74 636 (499-798)
1985-1989† 132,269 188 143 (122-165) 271 262 (230-293)
18-24 y 29,186 10 34 (16-63) 1 3 (0-19)
25-29 y 25,542 33 129 (89-181) 6 23 (9-51)
30-34 y 25,453 42 165 (119-223) 23 90 (57-136)
35-39 y 20,643 40 194 (138-264) 48 233 (171-308)
40-44 y 17,286 44 255 (185-342) 76 440 (346-550)
45-49 y 14,159 19 134 (81-210) 117 826 (683-990)
1990-1994† 139,863 99 67 (54-81) 365 299 (267-330)
18-24 y 25,815 4 15 (4-40) 1 4 (0-22)
25-29 y 25,695 11 43 (21-77) 7 27 (11-56)
30-34 y 26,935 20 74 (45-115) 31 115 (78-163)
35-39 y 23,538 31 132 (89-187) 55 234 (176-304)
40-44 y 20,739 25 121 (78-178) 113 545 (449-655)
45-49 y 17,141 8 47 (20-92) 158 922 (784-1,077)
1995-1999† 145,954 134 86 (71-101) 503 354 (323-385)
18-24 y 26,055 7 27 (11-55) 1 4 (0-21)
25-29 y 23,543 6 25 (9-55) 5 21 (7-50)
30-34 y 24,344 28 115 (76-166) 25 103 (66-152)
35-39 y 25,915 40 154 (110-210) 69 266 (207-337)
40-44 y 25,263 36 143 (100-197) 170 673 (576-782)
45-49 y 20,834 17 82 (48-131) 233 1,118 (979-1,272)
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 7 of 8
Calendar Year and
Age Groups Person-Years N
Incidence (95% CI)* (per 100,000 person-years)
N
Incidence (95% CI)* (per 100,000 person-years)
2000-2004† 151,296 146 92 (77-107) 554 357 (327-386)
18-24 y 26,776 9 34 (15-64) 1 4 (0-21)
25-29 y 23,743 11 46 (23-83) 6 25 (9-55)
30-34 y 23,435 25 107 (69-157) 34 145 (100-203)
35-39 y 26,390 38 144 (102-198) 56 212 (160-276)
40-44 y 26,945 34 126 (87-176) 191 709 (612-817)
45-49 y 24,007 29 121 (81-173) 266 1,108 (979-1,249)
2005-2009† 155,537 173 109 (92-125) 328 208 (186-231)
18-24 y 28,217 8 28 (12-56) 3 11 (2-31)
25-29 y 27,472 20 73 (44-112) 11 40 (20-72)
30-34 y 25,047 22 88 (55-133) 18 72 (43-114)
35-39 y 24,025 35 146 (101-203) 49 204 (151-270)
40-44 y 24,367 54 222 (166-289) 81 332 (264-413)
45-49 y 26,409 34 129 (89-180) 166 629 (537-732)
2010-2014† 161,005 146 90 (75-104) 187 116 (99-133)
18-24 y 29,621 3 10 (2-30) 1 3 (0-19)
25-29 y 30,263 16 53 (30-86) 6 20 (7-43)
30-34 y 26,494 28 106 (70-153) 10 38 (18-69)
35-39 y 23,020 30 130 (88-186) 27 117 (77-171)
40-44 y 23,244 39 168 (119-229) 49 211 (156-279)
45-49 y 28,363 30 106 (71-151) 94 331 (268-406)
2015-2018† 134,671 93 68 (54-82) 78 58 (45-71)
18-24 y 24,776 5 20 (7-47) 0 0 (0-0)
25-29 y 25,313 15 59 (33-98) 2 8 (1-29)
30-34 y 22,161 13 59 (31-100) 5 23 (7-53)
35-39 y 19,255 15 78 (44-128) 9 47 (21-89)
40-44 y 19,443 26 134 (87-196) 24 123 (79-184)
45-49 y 23,724 19 80 (48-125) 38 160 (113-220)
* Incidence rates were calculated by dividing the number of women who underwent a first unilateral or bilateral oophorectomy by the person-years at-risk in the Olmsted County population and multiplying by 100,000.
† The calendar-year specific incidence rates were age-adjusted to the total US female population from the 2010 Census. Therefore, although the age group specific incidence rates can be obtained by dividing the number of women by the corresponding person-years within each age group, the calendar-year specific incidence rates cannot be directly obtained by similar arithmetic.
Erickson Z, Rocca WA, Smith CY, Rocca LG, Stewart EA, Laughlin-Tommaso SK, et al. Time trends in unilateral and bilateral oophorectomy in a geographically defined American population. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 8 of 8
Appendix 3. Incidence per 100,000 person-years by ovarian pathology results for premenopausal unilateral or bilateral oophorectomy across three age groups (<40, 40‒45, and 46‒49 years) in 5-year calendar groups from 1950 to 2018. Note the y-axis differs for each age group. The pathology results were determined by a pathologist after the oophorectomy. For women with more than one result, we reported the most severe pathology. Cancer pathology includes primary and metastatic ovarian malignancy. Benign ovarian
pathology includes benign tumor (eg, cystadenoma, dermoid cyst, fibroma, teratoma), endometriosis, cyst, other inflammatory process (eg, abscess, adhesions), atrophy, and other ovarian lesions (eg, torsion, fibrosis, thecosis, endosalpingiosis, hemorrhage). The third group of women had normal ovarian pathology.
Cancer pathology Benign ovarian pathology Normal ovarian pathology
0 25 50 75 100 125 150 175
Unilateral oophorectomy Bilateral oophorectomy Age <40 y
1950 1960 1970 1980 1990 2000 2010 2020 0 25 50 75 100 125 150
175 Age <40 y
1950 1960 1970 1980 1990 2000 2010 2020
Age <40 y
0 25 50 75 100 125 150 175
1950 1960 1970 1980 1990 2000 2010 2020
0 100 200 300 400 500
1950 1960 1970 1980 1990 2000 2010 2020
Age 40-45 y
0 100 200 300 400 500
1950 1960 1970 1980 1990 2000 2010 2020
Age 40-45 y
0 100 200 300 400 500
1950 1960 1970 1980 1990 2000 2010 2020
Age 40-45 y
0 100 200 300 400 500 600 700
1950 1960 1970 1980 1990 2000 2010 2020
Age 46-49 y
0 100 200 300 400 500 600 700
1950 1960 1970 1980 1990 2000 2010 2020
Age 46-49 y
0 100 200 300 400 500 600 700
1950 1960 1970 1980 1990 2000 2010 2020
Age 46-49 y
Calendar year
Incidence per 100,000 person-years
