CPT 58520 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 80 - Assistant surgeon |
| Complexity Level | Moderate |
National average reimbursement for CPT 58520 by major payers:
$953.59
$1,066.22
$1,062.55
$1,317.74
| 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 58520 | ||||||
United | 58520 | $1955.00 | 1902218456 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY AT INDEPENDENCE MEDICAL VILLAGE | 470985876 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1028.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $11727.00 | 1154454205 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $100.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $289.00 | 1598847139 - ORTHOPAEDIC ASSOCIATES SURGERY CENTER, LLC | 582623564 - (GA) ORTHOPAEDIC ASSOCIATES SURGERY CTR, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $444.00 | 1962080853 - NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER LLC, NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER | 562049697 - (NC) CAROLINA HEALTHCARE ASSOCIATES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $2172.00 | 1609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER | 752592508 - (TX) DESOTO SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1670.00 | 1629664156 - OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER, OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER NEW ALBANY | 854149946 - (OH) OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $300.00 | 1700854072 - SULLIVAN SURGICENTER,LLC | 352124714 - (IN) SULLIVAN SURGICENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1167.00 | 1760818710 - YORK COUNTY OUTPATIENT ENDOSCOPY CENTER LLC | 463366385 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $665.00 | 1427092279 - IPM SURGERY CENTERS LLC, SPINALCARE SURGICENTER | 330983021 - (CA) IPM SURGERY CENTERS, INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $399.00 | 1467557678 - BEAN CENTER FOR FOOT SURGERY INC, SIERRA CENTER FOR FOOT SURGERY | 880309955 - (NV) BEAN CENTER FOR FOOT SURGERY INC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $775.00 | 1508342114 - ACTD,LLC, GREEN MOUNTAIN SURGERY CENTER | 472161109 - (VT) ACTDLLC | VT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $650.00 | 1114912102 - BOISE ENDOSCOPY CENTER, LLC | 820506078 - (ID) BOISE ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1049.00 | 1528077658 - PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC, PRINCE WILLIAM SURGERY CENTER | 770594498 - (VA) PRINCE WILLIAM AMBULATORY | VA | 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 58520 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58520 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 58520 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 |
|---|---|---|
| 58200-CPT | High | Total Abdominal Hysterectomy, Including Partial Vaginectomy, With Para-Aortic And Pelvic Lymph Node Sampling, With Or Without Removal Of Tube(S), With Or Without Removal Of Ovary(S) |
| 58240-CPT | High | Pelvic Exenteration For Gynecologic Malignancy With Total Abdominal Hysterectomy Or Cervicectomy With Or Without Removal Of Tube(S) With Or Without Removal Of Ovary(S) With Removal Of Bladder And Ureteral Transplantations And/Or Abdominoperineal Resection Of Rectum And Colon And Colostomy Or Any Combination Thereof |
| 58520-CPT | Moderate | Hysterorrhaphy Uterine Rupture |
| 58540-CPT | High | Hysteroplasty Uterine Anomaly |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58520 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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