CPT 58356 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures • 52 - Reduced Services |
| Complexity Level | High |
National average reimbursement for CPT 58356 by major payers:
$2,002.04
$2,564.09
$2,387.76
$3,065.68
| 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 58356 | ||||||
United | 58356 | $645.00 | 1679025449 - DIGESTIVE HEALTH COMPLEX | 262808532 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $2175.00 | 1366761397 - MEDINA-SUMMIT AMBULATORY SURGERY CENTER, THE MEDINA SURGERY CENTER | 261421110 - (OH) SUMMA HEALTH, PENSION ADMINISTATION COMMITTEE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1897.00 | 1477507168 - LAKESIDE SURGERY LLC, LAKESIDE SURGERY CENTER | 752714441 - LAKESIDE SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1350.00 | 1730124561 - SURGERY CENTER OF WESTON LLC | 650933685 - (FL) SURGERY CENTER OF WESTON LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1326.00 | 1598744732 - MIDWEST EYE SURGERY CENTER, LLC | 470831193 - (NE) MIDWEST EYE SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $699.00 | 1528307188 - SGFC SURGERY CENTER, LLC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $5354.00 | 1699284018 - ONYX & PEARL SURGICAL SUITES LLC | 821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $2938.00 | 1619933835 - MISSISSIPPI MEDICAL PLAZA, LC, MISSISSIPPI VALLEY SURGERY CENTER | 421429641 - (IA) MISSISSIPPI MEDICAL PLAZA, L.C. | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $4000.00 | 1801811443 - PHYSICIANS OF WINTER HAVEN LLC, DAY SURGERY CENTER | 200324393 - (FL) PHYSICIANS OF WINTER HAVEN, LLC DBA DAY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $11291.00 | 1568410926 - MERIDIAN MEDICAL GROUP PC, MERIDIAN ENDOSCOPY CENTER | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $5354.00 | 1881697522 - RIVERSIDE PARK SURGICENTER LLC | 593106055 - (FL) RIVERSIDE PARK SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $3318.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $5433.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1420.00 | 1952464844 - EDWARDSVILLE AMBULATORY SURGERY CENTER LLC | 371343371 - (IL) EDWARDSVILLE AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1471.00 | 1336208081 - ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | 593740436 - (FL) ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | FL | 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 58356 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58356 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 58356 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 |
| 58294-CPT | High | Vaginal Hysterectomy, For Uterus Greater Than 250 Grams With Repair Of Enterocele |
| 58301-CPT | Low | Removal Intrauterine Device |
| 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 58356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58356 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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