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 |
| Medicare Fee Schedule | View Medicare rates for 58520 |
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 | $743.00 | 1962772871 - SURGERY CENTER OF NORTHEAST TEXAS LLC, SURGERY CENTER OF NORTHEAST TEXAS | 454184639 - (TX) SCNETX, LLCDBA SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $4893.00 | 1033586136 - PHYSICIANS WEST HOUSTON SURGICAL CENTER, LLC, MEMORIAL HERMANN SURGERY CENTER PARK TEN | 371789833 | TX | 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 | $150.00 | 1205998648 - REGIONAL EYE ASSOCIATES, INC, SURGICAL EYE CENTER OF MORGANTOWN | 550740986 - REGIONAL EYE ASSOCIATES, INC. | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1274.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1167.00 | 1558487009 - MIDWEST DIGESTIVE HEALTH CENTER LLC | 431918703 - (MO) MIDWEST DIGESTIVE HEALTH CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1028.00 | 1255361259 - CENTRAL JERSEY SURGERY CENTER LLC, CENTRAL JERSEY SURGERY CENTER | 582352848 - (NJ) CENTRAL JERSEY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $346.00 | 1316484447 - CAPITAL CHILDREN'S HEALTHCARE | 812837189 - (MD) CAPITAL CHILDRENS HEALTHCARE | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $9124.00 | 1538292990 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $2345.00 | 1720161615 - MANKATO SURGICAL CENTER, L.L.C., MANKATO SURGERY CENTER | 411924647 - (MN) MANKATO SURGICAL CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $1477.00 | 1891717195 - CENTER FOR PAIN MANAGEMENT LLC, TUCSON UROLOGIC SURGERY CENTER | 830962530 - (AZ) CENTER FOR PAIN MANAGEMENT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58520 | $750.00 | 1114057023 - CROSSROADS SURGERY CENTER INC | 205799348 - (MN) CROSSROADS SURGERY CENTER INC | MN | 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 | $373.00 | 1124296173 - TREASURE COAST SURGICAL CENTER INC | 260770428 - (FL) TREASURE COAST SURGICAL CENTER, INC. | FL | 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 | 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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