CPT 58543 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 • 80 - Assistant surgeon • 22 - Increased Procedural Services |
| Complexity Level | High |
National average reimbursement for CPT 58543 by major payers:
$1,068.33
$1,177.30
$1,165.47
$1,449.22
| 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 58543 | ||||||
United | 58543 | $2023.00 | 1336103001 - PERKINS PLAZA AMBULATORY SURGERY CENTER LLC, LAKE SURGERY CENTER | 481264699 - (LA) LAKE ASC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $4865.00 | 1215381843 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $6588.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $943.00 | 1811929300 - COASTAL DIGESTIVE CARE CENTER LLC | 20621976 - (CT) COASTAL DIGESTIVE CARE CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $1339.00 | 1467788729 - WATERFORD SURGICAL CENTER, LLC | 271110813 - (MI) WATERFORD SURGICAL CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $1645.00 | 1942455449 - HEA GRAMERCY SURGERY CENTER, PLLC, HEA SURGERY CENTER | 263722257 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $7581.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $5200.00 | 1548842180 - DIGESTIVE HEALTH CENTER LLC | 853810510 - (IA) DIGESTIVE HEALTH CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $4200.00 | 1629536826 - MEADOWVIEW ASC, LLC | 832440695 - (TN) MEADOWVIEW ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $1222.00 | 1174615702 - I CARE CENTER LLC, CENTRAL INDIANA SURGERY CENTER | 351937200 - (IN) ICARE CENTER DBA CENTRAL INDIANA SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $6365.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $1610.00 | 1306486634 - FREDERICKSBURG ENDOSCOPY CENTER, LLC | 834398314 - (VA) FREDERICKSBURG ENDOSCOPY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $12945.00 | 1326286360 - NORTH CAMPUS SURGERY CENTER LLC | 352147088 - (IN) NORTH CAMPUS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $6130.00 | 1669660817 - SPH IRVINE, L.L.C. | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58543 | $987.00 | 1104125939 - GASTROENTEROLOGY CARE INC | 263101232 - (NY) GASTROENTEROLOGY CARE INC | NY | 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 58543 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58543 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 58543 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 |
|---|---|---|
| 58150-CPT | High | Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With Or Without Removal Of Ovary(S); |
| 58180-CPT | High | Supracervical Abdominal Hysterectomy (Subtotal Hysterectomy), With Or Without Removal Of Tube(S), With Or Without Removal Of Ovary(S) |
| 58542-CPT | High | Laparoscopy, Surgical, Supracervical Hysterectomy, For Uterus 250 G Or Less; With Removal Of Tube(S) And/Or Ovary(S) |
| 58543-CPT | High | Partial Removal Of Uterus (Greater Than 250 Grams) With Retention Of Cervix Using An Endoscope |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58543 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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