CPT 58291 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 58291 by major payers:
$1,625.34
$1,679.63
$1,689.56
$2,061.74
| 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 58291 | ||||||
United | 58291 | $1500.00 | 1184601221 - CLAY SURGERY CENTER LLP | 10670335 - (FL) CLAY SURGERY CENTER LLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $4992.00 | 1770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA | 364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $1500.00 | 1669621496 - CPM SURGERY CENTER 3, LLC | 263297851 - (GA) CPM SURGERY CENTER 3 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $5035.00 | 1538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC | 205170962 - (CA) PHYSICIANS SURGERY CENTER OF | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $1636.00 | 1265455463 - THE ENDOSCOPY CENTER AT BEL AIR | 470863243 - (MD) THE ENDOSCOPY CENTER AT BEL AIR | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $710.00 | 1790902617 - WEST WICHITA FAMILY PHYSICIANS, P.A., WEST WICHITA SURGERY CENTER | 742848808 - (KS) WEST WICHITA FAMILY PHYSICIANS, P.A. | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $1150.00 | 1093726309 - INSIGHT SURGERY & LASER CENTER, LLC | 203458868 - (OH) INSIGHT SURGERY LASER CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $3275.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $5020.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $3404.00 | 1255796017 - GOSHEN HEALTH SURGERY CENTER, LLC | 475619052 - (IN) GOSHEN HEALTH SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $1417.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $910.00 | 1972156842 - NORMAN REGIONAL HOSPITAL AUTHORITY, MEDICAL PLAZA ENDOSCOPY | 736048282 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $800.00 | 1922071315 - SENECA PA ASC LLC, THE SURGERY AND LASER CENTER | 621806254 - (PA) SENECA PA ASC, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $2014.00 | 1083873277 - VENTURE AMBULATORY SURGERY CENTER LLC | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58291 | $4312.00 | 1437597812 - VIVERE HEALTH AUSTIN, LLC, VIVERE AUSTIN SURGERY CENTER | 611694454 - (TX) VIVERE HEALTH AUSTIN LLC | 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 |
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CPT 58291 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58291 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 58291 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 |
|---|---|---|
| 58263-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Removal Of Tube(S), And/Or Ovary(S), With Repair Of Enterocele |
| 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) |
| 58292-CPT | High | Vaginal Hysterectomy For Uterus Greater Than 250 Grams; With Removal Of Tube(S) And/Or Ovary(S) With Repair Of Enterocele |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58291 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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