CPT 58540 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | High |
National average reimbursement for CPT 58540 by major payers:
$1,158.94
$1,221.74
$1,181.05
$1,510.41
| 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 58540 | ||||||
United | 58540 | $109.00 | 1073588356 - DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA, LLC | 201456252 - (AZ) DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $936.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $1274.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $500.00 | 1033375399 - ABILENE SURGERY CENTER, LLC | 208816729 - (TX) ABILENE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $1887.00 | 1831576891 - ADVANCED SURGERY CENTER PERIMETER, LLC | 473080613 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $768.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $480.00 | 1740785096 - GASTROINTESTINAL ENDOSCOPY CENTER LLC | 822081770 - (PA) GASTROINTESTINAL ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $954.00 | 1639164916 - THE SURGERY CENTER AT SACRED HEART MEDICAL PARK, DESTIN, LLC | 562315052 - (FL) THE SURGERY CENTER AT SACRED HEART MEDICAL PARK DESTIN LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $1093.00 | 1508005976 - SOUTH SHORE SC, LLC | 341997077 - (NY) SOUTH SHORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $459.00 | 1487765897 - BAY MICROSURGICAL UNIT | 570799855 - (SC) BAY MICROSURGICAL UNIT | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $451.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $651.00 | 1588332712 - HAND ASC LLC | 872342845 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $1064.00 | 1093085904 - ARIZONA ADVANCED ENDOSCOPY LLC | 453051125 - (AZ) ARIZONA ADVANCED ENDOSCOPY, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $112.00 | 1235102344 - THE HARLINGEN ENDOSCOPY CENTER LP, VALLEY ENDOSCOPY CENTER | 621839180 - (TX) THE HARLINGEN ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58540 | $578.00 | 1053630137 - WILMINGTON SURGICAL SERVICES LLC | 272503795 - (OH) WILMINGTON SURGICAL SERVICES LLC | OH | 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 58540 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58540 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 58540 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 |
|---|---|---|
| 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 |
| 58285-CPT | High | Hysterectomy Vaginal Radical |
| 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 58540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58540 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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