CPT 58263 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 • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 58263 by major payers:
$1,280.55
$1,335.44
$1,336.85
$1,645.76
| 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 58263 | ||||||
United | 58263 | $950.00 | 1407095359 - PAIN CARE CENTER OF GEORGIA LLC | 300523580 - (GA) PAIN CARE CENTER OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $1849.00 | 1881845907 - NORTH PACIFIC DERMATOLOGY PS | 204269950 - (WA) NORTH PACIFIC DERMATOLOGY PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $3347.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $1735.00 | 1760598577 - ACUTE & CHRONIC PAIN MANAGEMENT CENTER PA, ACUTE & CHRONIC PAIN AND SPINE CENTER | 752711926 - (TX) ACUTE AND CHRONIC PAIN AND SPINE CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $1460.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $5772.00 | 1427017987 - BAPTIST SURGERY CENTER LP, BAPTIST AMBULATORY SURGERY CENTER | 621672473 - (TN) BAPTIST SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $2800.00 | 1063750867 - MENLO PARK SURGERY CENTER, LLC. | 263669436 - (NJ) MENLO PARK SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $1868.00 | 1205076593 - HEALTHCARE PARTNERS ASC-HB, LLC, TALBERT SURGICAL ASSOCIATES, LLC | 264247365 - (CA) HEALTHCARE PARTNERS ASCHB LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $3350.00 | 1851338677 - DELAWARE SURGERY CENTER, LLC | 510401940 - (DE) DELAWARE SURGERY CENTER, LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $3632.00 | 1144948167 - MCALLEN SURGICENTER, LLC, MCALLEN SURGERY CENTER | 862290088 - (TX) MCALLEN SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $3169.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $3629.00 | 1316072234 - ARIA HEALTH SYSTEM, ARIA HEALTH FRANKFORD CAMPUS SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $793.00 | 1821336371 - EYECARE SURGERY CENTER, LLC | 461073660 - (MS) EYECARE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $2924.00 | 1306135298 - DMG PAIN MANAGEMENT SURGERY CENTER, LLC | 271322187 - (IL) DMG PAIN MANAGEMENT SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58263 | $2010.00 | 1053634030 - DALLAS NEPHROLOGY ASSOCIATES, DALLAS NEPHROLOGY ASSOCIATES VASCULAR CENTER DALLAS | 751366650 - (TX) DALLAS NEPHROLOGY ASSOCIATES, P.A. | TX | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 58263 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58263 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 58263 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 |
|---|---|---|
| 58262-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Removal Of Tube(S), And/Or Ovary(S) |
| 58263-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Removal Of Tube(S), And/Or Ovary(S), With Repair Of Enterocele |
| 58267-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Colpo-Urethrocystopexy (Marshall-Marchetti-Krantz Type, Pereyra Type) With Or Without Endoscopic Control |
| 58356-CPT | High | Endometrial Cryoablation With Ultrasonic Guidance, Including Endometrial Curettage, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58263. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58263 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 58263) and we'll show you how you compare in 15 minutes or less.