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See a sample rate comparisonCPT 58100 Fee Schedule
Medicare rates as of October 2026
CPT 58100 is classified under Surgery, in the Surgical Procedures on the Female Genital System subgroup.
Biopsy Of The Uterine Lining, A Procedure To Remove A Sample Of Tissue From The Lining Of The Uterus For Testing (Biopsy). The Procedure May Include Examining The Cervix With A Scope (Colposcopy) And Taking Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Female Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | AG - Primary physician 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $98.20 national non-facility rate (2026) · View Medicare rates for 58100 |
| Medicaid Fee Schedule | $78.065 median of the 8 states in the free preview · View Medicaid rates for 58100 |
National average reimbursement for CPT 58100 by major payers:
$122.26
BCBS / Anthem
$137.66
UnitedHealthcare
$146.16
Aetna
$121.23
Cigna
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CPT 58100
5 of 25 sample ratesHigher to lower in this preview
Memorial Surgery Center, LLC
Memorial Surgery Center LLC
$566.00Published rateAshanda Saint Jean
Westchester Medical Center Advanced Physician Services, P.C
$216.96Published rateDeaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$162.88Published rateMadison Co Memorial Hospital, Seasons Medical By Madison Memorial
$124.26Published rateKristine Hays
Deaconess Hospital Inc
$74.83Published rate
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See a sample payer proposalCPT 58100 vs. Other Surgical Procedures on the Female Genital System Codes
The table lists codes related to 58100. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 57720-CPT | Moderate | Trachelorrhaphy Plstic Rpair Of Uterine Cervix Vagnal Approa, Trachelorrhaphy Plastic Repair Of Uterine Cervix Vaginal Approach |
| 57800-CPT | Low | Dilation Cervical Canal |
| 58100-CPT | Low | Biopsy Of The Uterine Lining, A Procedure To Remove A Sample Of Tissue From The Lining Of The Uterus For Testing (Biopsy). The Procedure May Include Examining The Cervix With A Scope (Colposcopy) And Taking Tissue For Testing (Biopsy). |
| 58345-CPT | Moderate | Place Fallopian Tube Catheter, Placement Of A Small Tube (Catheter) Into A Fallopian Tube To Enable Liquid To Flow Through. The Procedure May Use A Scope (Hysterosalpingoscope) To View The Area. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58100 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT stands for Current Procedural Terminology. These codes are a medical code set developed by the American Medical Association (AMA) and are used by healthcare professionals to uniformly describe medical, surgical, and diagnostic services. They are crucial for billing and reporting healthcare services to insurance companies and government payers.
To find the cost of a specific medical procedure tailored to your location, you can utilize Payerprice's fee schedule lookup tool. This tool allows you to search using the CPT code for the procedure and specify your location to get a more accurate estimate of potential costs.
CMS (Centers for Medicare & Medicaid Services) provides fee schedules primarily for services covered by Medicare, with rates specific to Medicare beneficiaries. Payerprice offers a fee schedule lookup tool allowing users to search with CPT codes and specific locations, providing a broader view of market-based pricing and typical fee schedules for a wider range of commercial payer rates. For personalized cost estimates based on your specific situation and location, Payerprice is recommended.
Yes, absolutely. CPT codes are listed on your medical bill and correspond to the specific medical, surgical, or diagnostic services you received. By identifying these codes, you can cross-reference them with your Explanation of Benefits (EOB) from your insurance company to understand exactly what services you are being charged for and how your insurance plan is processing those charges.
Payerprice's fee schedule lookup tool provides valuable market-based pricing data and typical fee schedules based on CPT codes and specific locations. While it may not reflect the exact, specific negotiated rate between every single insurance plan and every individual provider, it offers a strong basis for understanding potential costs and comparing prices. For the most precise cost for your particular insurance plan and provider, it is always advisable to also contact your insurance provider directly.