CPT 58260 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58260 |
National average reimbursement for CPT 58260 by major payers:
$1,084.26
$1,116.49
$1,166.18
$1,385.57
| 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 58260 | ||||||
United | 58260 | $920.00 | 1073581880 - AMBULATORY SURGERY CENTER LLC, THE CENTER FOR SAME DAY SURGERY | 481114690 - (KS) AMBULATORY SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $3347.00 | 1831420694 - TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC | 263531997 - (FL) TITUSVILLE CENTER FOR SURGICAL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $788.00 | 1245399757 - KUMAR SURGICAL CENTER LLC | 383530839 - (MI) KUMAR SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $6189.00 | 1275682148 - TEMPLE UNIVERSITY HOSPITAL, INC | 232825878 - (PA) TEMPLE UNIVERSITY HOSPITAL INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $3570.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $1550.00 | 1033115472 - CAPLAN-BERKELEY, LLP, CAPLAN SURGERY CENTER | 571146952 - (TX) CAPLANBERKELEY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $3623.00 | 1326527680 - INTRACOASTAL SURGERY CENTER, LLC | 824525706 - (FL) INTRACOASTAL SURGERY CENTER LL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $3623.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $1700.00 | 1154887040 - JESC LLC | 812351158 - (IN) JESC LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $831.00 | 1679556864 - DOCTORS GI PARTNERSHIP LTD, HF SURGERY CENTER AT BABCOCK | 593758988 - (FL) DOCTORS GI PARTNERSHIP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $2637.00 | 1477070340 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT SOUTH PALM | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $2403.00 | 1124125331 - AMBULATORY SURGERY ASSOCIATES, LLC, BROOKSIDE SURGERY CENTER | 383237596 - (MI) AMBULATORY SURGERY ASSOCIATES | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $1310.00 | 1902981558 - LANE SURGERY CENTER, LLC | 931305103 - (OR) LANE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $1750.00 | 1669405684 - PACIFICOAST AMBULATORY SURGICENTER, LLC., PACIFIC COAST AMBULATORY SURGICENTER | 474003673 - (CA) PACIFICOAST AMBULATORY SURGICENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58260 | $2549.00 | 1174010011 - DTC SURGERY CENTER, LLC, OCC SURGERY CENTER AT INVERNESS | 825181311 - (CO) DTC SURGERY CENTER LLC | CO | 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 58260 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58260 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 58260 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 |
|---|---|---|
| 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) |
| 58260-CPT | High | Vaginal Hysterectomy For Uterus 250 Grams Or Less; (Desc Rev 01/01/03) |
| 58262-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Removal Of Tube(S), And/Or Ovary(S) |
| 58275-CPT | High | Vaginal Hysterectomy, With Total Or Partial Vaginectomy; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58260 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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