CPT 58285 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 • 80 - Assistant surgeon • 22 - Increased Procedural Services |
| Complexity Level | High |
National average reimbursement for CPT 58285 by major payers:
$1,707.60
$1,847.52
$1,871.86
$2,321.76
| 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 58285 | ||||||
United | 58285 | $775.00 | 1801994553 - BARRINGTON SURGICAL CARE LLC, BARRINGTON SURGICAL CARE | 203991455 - (NH) BARRINGTON SURGICAL CARE LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $775.00 | 1316350275 - ORCHARD SURGICAL CENTER, LLC, ORCHARD SURGICAL CENTER | 465568612 - (NH) ORCHARD SURGICAL CENTER, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $582.00 | 1841589116 - RENAISSANCE SURGERY CENTER OF CHATTANOOGA, LLC | 273013392 - (TN) RENAISSANCE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $408.00 | 1114996774 - REDBIRD SQUARE ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER AT REDBIRD SQUARE | 752816071 - (TX) REDBIRD SQUARE ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $250.00 | 1003036310 - MIDWEST ENDOSCOPY CENTER LLC | 208292570 - (IL) MIDWEST ENDOSCOPY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $654.00 | 1679544050 - TUSCALOOSA SURGICAL CENTER LP, TUSCALOOSA SUR | 630974161 - (AL) TUSCALOOSA SURGICAL CENTER LP | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $623.00 | 1225665292 - ANNAPOLIS ENDOSCOPY CENTER LLC | 843556524 - (MD) ANNAPOLIS ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $2069.00 | 1114924685 - SOUTH KANSAS CITY SURGICAL CENTER, LC, SOUTH KANSAS CITY SURGICENTER | 202181884 - (KS) SOUTH KANSAS CITY SURGICAL CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $1028.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $410.00 | 1487122669 - CONWAY CARDIOVASCULAR SURGERY CENTER, LLC | 832435695 - (AR) CONWAY CARDIOVASCULAR SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $731.00 | 1548216914 - UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | 450470832 - (TN) UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $650.00 | 1508810656 - RETINAL AMBULATORY SURGERY CENTER OF NEW YORK, INC. | 134189700 - (NY) RETINAL AMBULATORY SURGERY CENTER OF NY, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $1049.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $402.00 | 1083601298 - LAHAYE CENTER FOR ADVANCED EYE CARE, APMC, LAHAYE EYE CLINIC | 720988221 - (LA) LAHAYE EYE CLINIC, P.C. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58285 | $580.00 | 1679939318 - CRATER LAKE SURGERY CENTER LLC | 475641623 - (OR) CRATER LAKE SURGERY CENTER LLC | OR | 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 58285 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58285 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 58285 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 |
| 58260-CPT | High | Vaginal Hysterectomy For Uterus 250 Grams Or Less; (Desc Rev 01/01/03) |
| 58270-CPT | High | Vaginal Hysterectomy, With Or Without Removal Of Tube(S), With Or Without Removal Of Ovary(S); With Repair Of Entero |
| 58285-CPT | High | Hysterectomy Vaginal Radical |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58285 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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