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 |
| Medicare Fee Schedule | View Medicare rates for 58356 |
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 | $6912.00 | 1164056974 - ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC | 842016212 - (WI) ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $5249.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | 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 | $3154.00 | 1710615869 - ORTHOILLINOIS SURGERY CENTER ELGIN, LLC | 851212739 - (IL) ORTHOILLINOIS SURGERY CENTER ELGIN LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $2509.00 | 1487609335 - THE CENTER FOR AESTHETIC SURGERY LLC | 200431536 - (MD) THE CENTER FOR AESTHETIC SURGERY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1457.00 | 1386641066 - EYE SURGERY CENTER OF MARYVILLE LLC, EYES OF ILLINOIS SURGERY CENTER | 364111317 - (IL) NOVAMED EYE SURGERY CENTER OF MARYVILLE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $5020.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $1003.00 | 1578600979 - HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER, METRO AMBULATORY SURGICAL CENTER | 522048920 - (MD) HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER | MD | 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 | $874.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | 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 | $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 | $2370.00 | 1508846122 - HEALTH & WELLNESS SURGERY CENTER, TOWER SURGERY CENTER | 562437008 - (CA) HEALTH WELLNESS SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $3484.00 | 1578534459 - BOSTON OUT-PATIENT SURGICAL SUITES, LLC | 270050256 - (MA) BOSTON OUT-PATIENT SURGICAL SUITES, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58356 | $2978.00 | 1114291440 - PREMIER ASC LLC, PREMIER ORTHOPAEDIC SURGERY CENTER | 352433859 | TN | 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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