Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 49322 refers to a laparoscopic surgical technique that involves the aspiration of fluid from a cavity or cyst, such as an ovarian cyst. This minimally invasive approach begins with the placement of a port near the umbilicus, through which a pneumoperitoneum is established by insufflating air into the abdominal cavity. This process allows for the expansion of the abdominal space, providing the surgeon with a clear view of the internal structures using a laparoscope equipped with a video camera. The laparoscope enables thorough inspection of the abdominal cavity, peritoneum, and omentum for any signs of malignancy, disease, or injury. Once the target cavity or cyst is identified, an aspiration needle is introduced through the laparoscope to puncture the cyst or cavity, allowing for the extraction of fluid. This procedure can involve the aspiration of fluid from multiple cavities or cysts if necessary. After the aspiration is completed, the surgeon inspects the puncture sites for any bleeding, which can be controlled using laser or electrocautery techniques. Finally, the instruments are carefully withdrawn, and pressure is applied to the abdomen to expel any residual air from the peritoneal cavity before closing the portal incisions. This technique is valued for its reduced recovery time and minimal scarring compared to traditional open surgical methods.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 49322 is indicated for the aspiration of fluid from cysts or cavities within the abdominal cavity. The following conditions may warrant this procedure:

  • Ovarian Cysts The presence of ovarian cysts that require fluid removal to alleviate symptoms or for diagnostic purposes.
  • Peritoneal Cysts The aspiration of fluid from peritoneal cysts that may be causing discomfort or other complications.
  • Diagnostic Evaluation Situations where fluid analysis is necessary to determine the nature of the cystic fluid, which may assist in diagnosing underlying conditions.

2. Procedure

The laparoscopic aspiration procedure begins with the establishment of a periumbilical port, which serves as the entry point for the laparoscope. The surgeon insufflates the abdominal cavity with air to create a pneumoperitoneum, allowing for better visualization of the internal structures. Once the abdominal cavity is adequately inflated, the laparoscope is inserted through the port. This instrument, equipped with a video camera, provides a clear view of the entire abdominal cavity, including the peritoneum and omentum, enabling the surgeon to inspect for any signs of malignancy, disease, or injury.

After a thorough inspection, the surgeon locates the target cavity or cyst. An aspiration needle is then carefully inserted through the laparoscope to puncture the cyst or cavity. This step is crucial as it allows for the extraction of fluid, which can be performed on one or multiple cavities or cysts as needed. The fluid is aspirated, and the volume and characteristics of the fluid may be noted for further analysis.

Upon completion of the aspiration, the surgeon inspects the puncture sites for any signs of bleeding. If bleeding is observed, it is controlled using laser or electrocautery techniques to ensure patient safety. Following this, the instruments are withdrawn from the abdominal cavity. To finalize the procedure, pressure is applied to the abdomen to express any remaining air from the peritoneum. Finally, the portal incisions are closed, completing the laparoscopic aspiration procedure.

3. Post-Procedure

After the laparoscopic aspiration procedure, patients are typically monitored for any immediate complications, such as bleeding or infection. Recovery may vary depending on the individual and the extent of the procedure, but patients can generally expect a shorter recovery time compared to traditional open surgery. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Follow-up appointments may be scheduled to assess the patient's recovery and to discuss the results of any fluid analysis performed on the aspirated material.

Short Descr LAPAROSCOPY ASPIRATION
Medium Descr LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
Long Descr Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 49320  Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 87 - Laparoscopy

This is a primary code that can be used with these additional add-on codes.

49327 Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2011-01-01 Changed Short description changed.
2001-01-01 Changed Code description changed.
2000-01-01 Added First appearance in code book in 2000.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"