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See a sample rate comparisonCPT 58294 Fee Schedule
Last Verified: September 2026
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.
Vaginal Hysterectomy, Surgery To Remove The Uterus Through The Cervix (Vaginal Hysterectomy). The Procedure May Be Aided By A Scope (Laparoscope). The Fallopian Tubes Or Ovaries Also May Be Removed.
| 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 82 - Assistant surgeon - no qualified resident GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58294 |
| Medicaid Fee Schedule | View Medicaid rates for 58294 |
National average reimbursement for CPT 58294 by major payers:
$1,527.69
$1,639.56
$1,607.41
$1,972.12
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CPT 58294
5 of 25 sample ratesHigher to lower in this preview
Northshore Regional Medical Center Dba The Surgery Suite, The Surgery Suite
Ochsner Clinic Foundation
$21,412.00Published rateAnkeny Medical Park Surgery Center Lc
$4,975.08Published rateBaptist Surgery And Endoscopy Centers LLC, Baptist Health Surgery Center At Northpoint
$3,320.00Published rateEast Side Endoscopy LLC
$1,306.00Published rateMcdowell Ambulatory Surgery Center LLC
$153.00Published rate
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See a sample payer proposalCPT 58294 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58294 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 58294 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, Surgery To Remove The Uterus Through The Cervix (Vaginal Hysterectomy). The Procedure May Be Aided By A Scope (Laparoscope). The Fallopian Tubes Or Ovaries Also May Be Removed. |
| 58290-CPT | High | Vaginal Hysterectomy, Surgery To Remove The Uterus Through The Cervix (Vaginal Hysterectomy). The Procedure May Be Aided By A Scope (Laparoscope). The Fallopian Tubes Or Ovaries Also May Be Removed. |
| 58292-CPT | High | Vaginal Hysterectomy, Surgery To Remove The Uterus Through The Cervix (Vaginal Hysterectomy). The Procedure May Be Aided By A Scope (Laparoscope). The Fallopian Tubes Or Ovaries Also May Be Removed. |
| 58294-CPT | High | Vaginal Hysterectomy, Surgery To Remove The Uterus Through The Cervix (Vaginal Hysterectomy). The Procedure May Be Aided By A Scope (Laparoscope). The Fallopian Tubes Or Ovaries Also May Be Removed. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58294. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58294 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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