CPT 58200 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Female Genital System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58200 |
National average reimbursement for CPT 58200 by major payers:
$1,600.39
$1,801.91
$1,811.81
$2,231.35
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 58200 | ||||||
United | 58200 | $1064.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $3022.00 | 1457682841 - PAIN CARE OF NORTH TEXAS | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $633.00 | 1558497263 - ARTHUR N DONALDSON M D INC, SONORA EYE SURGERY CENTER | 942593611 - ARTHUR N DONALDSON MD INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1350.00 | 1255397964 - SURGERY CENTERS OF DES MOINES LTD | 363562598 | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $785.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1049.00 | 1942507488 - GA ENDOSCOPY CENTER, LLC | 273115800 - (GA) GA ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1001.00 | 1376634683 - MONTGOMERY SURGICAL CENTER, LTD | 752365748 - (AL) MONTGOMERY SURGICAL CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $807.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1049.00 | 1992796742 - SAN ANTONIO ENDOSCOPY, LP, SAN ANTONIO ENDOSCOPY CENTER | 202511329 - (TX) SAN ANTONIO ENDOSCOPY LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1049.00 | 1083624670 - PRESCOTT OUTPATIENT SURGICAL CENTER LLC | 860548048 - (AZ) PRESCOTT OUTPATIENT SURGICAL CENTER, LP | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $137.00 | 1225452303 - MARTHA JEFFERSON HOSPITAL, MARTHA JEFFERSON OUTPATIENT SURGERY CENTER | 540261840 - (VA) MARTHA JEFFERSON HOSPITAL | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $653.00 | 1922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC | 640897321 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $317.00 | 1053345082 - EYE SURGERY LIMITED LLC, VIRGINIA CENTER FOR EYE SURGERY | 522406179 - (VA) EYE SURGERY LIMITED, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $1390.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58200 | $622.00 | 1801952783 - AMBULATORY SURGICENTER OF DOWNERS GROVE | 364106726 - (IL) AMBULATORY SURGICENTER OF DOWNERS GROVE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 58200 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58200 code is part of the Surgery services used for Surgical Procedures on the Female Genital System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 58200 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 58146-CPT | High | Myomectomy Excision Of Fibroid Tumor(S) Of Uterus 5 Or More Intramural Myomas And/Or Intramural Myomas With Total Weight Greater Than 250 Grams Abdominal Approach |
| 58200-CPT | High | 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 | High | 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) |
| 58280-CPT | High | Removal Of Uterus And Vagina With Repair Of Herniated Bowel Into Rectum Or Vagina Through Vagina |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58200 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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