CPT 58290 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 • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 58290 by major payers:
$1,389.20
$1,548.66
$1,540.77
$1,904.52
| 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 58290 | ||||||
United | 58290 | $1467.00 | 1457898215 - PROSPECT BLACKSTONE VALLEY SURGICARE, LLC, BLACKSTONE VALLEY SURGICARE | 814871794 - (RI) PROSPECT BLACKSTONE VALLEY SURGICARE LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $651.00 | 1619940582 - FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC, CENTER FOR DIGESTIVE HEALTH AND PAIN MANAGEMENT | 621848758 - (FL) FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $5433.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $2693.00 | 1609996149 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $3407.00 | 1861931263 - METHODIST CRAIG RANCH SURGERY CENTER LLC | 352583971 - (TX) METHODIST CRAIG RANCH SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $1248.00 | 1902849227 - EYE SURGERY CENTER, LLC | 371221499 - (IL) EYECARE MANAGEMENT, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $2738.00 | 1487604500 - CYPRESSWOOD SURGERY CENTER LLC, LEGENT SURGERY CENTER CYPRESSWOOD | 680600120 - (TX) CYPRESSWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $1632.00 | 1225070527 - LIBERTY CATARACT CENTER LLC | 743099283 - (MO) LIBERTY CATARACT CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $5249.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $5249.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $1201.00 | 1811933179 - KALAMAZOO ENDO CENTER LLC | 201582174 - (MI) KALAMAZOO ENDO CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $5433.00 | 1841712452 - SAINT THOMAS SURGERY CENTER NEW SALEM, LLC | 822137177 - (TN) SAINT THOMAS SURGERY CENTER NEW SALEM LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $1550.00 | 1457323107 - BOCA RATON OPHTHALMOLOGY ASC LLC, OUTPATIENT SURGERY CENTER OF BOCA RATON | 626350623 - (FL) BOCA RATON OPHTHALMOLOGY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $699.00 | 1437232758 - SHADY GROVE REPRODUCTIVE SCIENCE CENTER PC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58290 | $5522.00 | 1104189042 - FOOTHILLS SURGERY CENTER, LLC | 455328252 - (CO) FOOTHILLS 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 58290 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58290 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 58290 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 |
|---|---|---|
| 58290-CPT | High | Vaginal Hysterectomy, For Uterus Greater Than 250 Grams; |
| 58291-CPT | High | Vaginal Hysterectomy, For Uterus Greater Than 250 Grams: With Removal Of Tube(S) And/Or Ovary(S) |
| 58294-CPT | High | Vaginal Hysterectomy, For Uterus Greater Than 250 Grams With Repair Of Enterocele |
| 58340-CPT | Moderate | Catheterization And Introduction Of Saline Or Contrast Material For Saline Infusion Sonohysterography (Sis) Or Hysterosalpingography (Rvsd 1/1/04) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58290. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58290 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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