What is a CPT code and why is it important for understanding medical costs?

A CPT (Current Procedural Terminology) code is a standardized five-digit code used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for understanding medical costs because they are used for billing and to communicate consistently across the healthcare system. Knowing the CPT code for a service you need can help you research its typical cost and understand your medical bills.

How can I find out the cost of a specific medical procedure or service before I receive it?

To find out the cost of a specific medical procedure or service, you can first ask your provider for the CPT code of the service. Then, you can use price transparency tools. For detailed, location-specific fee schedule lookups using CPT codes, you can utilize resources like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get an estimate of costs. Additionally, your insurance company may have tools or be able to provide estimates.

Why do healthcare costs vary so much between different providers or locations?

Healthcare costs can vary significantly due to several factors including differences in provider overhead, negotiated rates with insurance companies, the complexity of the procedure, geographic location, technology used, and the provider's specific pricing strategy. Hospitals and larger facilities often have different cost structures compared to independent practices.

What should I do if I receive a medical bill that seems too high or unexpected?

If you receive a medical bill that seems too high or unexpected, first, don't panic. Carefully review the bill for any errors and compare it against your Explanation of Benefits (EOB) from your insurance company. If you have questions, contact the provider's billing department to ask for an itemized bill and an explanation of the charges. You can also negotiate the price or payment plan. For pricing benchmarks, you can use tools like Payerprice to see typical costs for the services billed based on their CPT codes and your location.

Is there a way to compare prices for healthcare services in my area?

Yes, there are ways to compare prices for healthcare services. Many insurance companies offer price comparison tools for their members. Independent platforms and resources also exist. For specific fee schedule information using CPT codes and your location, Payerprice offers a dedicated lookup tool that can help you compare potential costs for various services. This allows you to make more informed decisions about where to seek care.

CPT 58545 Fee Schedule

Last Verified: October 2026

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.

Laparoscopic Myomectomy, Laparoscopy Surgical Myomectomy Excision; 1 To 4 Intramural Myomas With Total Weight Of 250 Grams Or Less And/Or Removal Of Surface Myomas

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Female Genital System
Common Place of Service	22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center
Common Modifiers	None AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 58545
Medicaid Fee Schedule	View Medicaid rates for 58545

National average reimbursement for CPT 58545 by major payers:

$1,108.53

$1,208.38

$1,278.88

$1,461.62

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 58545.

CPT 58545

5 of 25 sample ratesHigher to lower in this preview

Meridian Medical Group PC, Meridian Endoscopy Center
INAmbulatory Surgical Clinic/CenterNPI 1568410926Tax ID 20-8398421
$11,291.00Published rate
Spalding Triangle Surgery Center, LLC, Spalding Triangle Surgery Center
Spalding Triangle Surgery Center LLC
CAAmbulatory Surgical Clinic/CenterNPI 1720023484Tax ID 76-0769099
$5,466.00Published rate
Midwest Surgery Center Inc
NEAmbulatory Surgical Clinic/CenterNPI 1467580019Tax ID 20-4139967
$2,980.00Published rate
Meridian Surgery Center LLC
MDAmbulatory Surgical Clinic/CenterNPI 1528680865Tax ID 84-5179604
$1,700.00Published rate
Palmetto Endoscopy Center
SCAmbulatory Surgical Clinic/CenterNPI 1861073371Tax ID 82-3095588
$699.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 58545 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 58545 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 58545 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
58140-CPT	High	Myomectomy Abdom Method, Myomectomy Excision Of Fibroid Tumor S Of Uterus 1 To 4 Intramural Myoma S With Total Weight Of 250 G Or Less And Or Removal Of Surface Myomas Abdominal Approach
58145-CPT	Moderate	Myomectomy Vag Method, Myomectomy Excision Of Fibroid Tumor S Of Uterus 1 To 4 Intramural Myoma S With Total Weight Of 250 G Or Less And Or Removal Of Surface Myomas Vaginal Approach
58323-CPT	Low	Sperm Washing For Artificial Insemination
58545-CPT	High	Laparoscopic Myomectomy, Laparoscopy Surgical Myomectomy Excision; 1 To 4 Intramural Myomas With Total Weight Of 250 Grams Or Less And/Or Removal Of Surface Myomas

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 58545 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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CPT 58545 Fee Schedule

Meridian Medical Group PC, Meridian Endoscopy Center

Spalding Triangle Surgery Center, LLC, Spalding Triangle Surgery Center

Midwest Surgery Center Inc

Meridian Surgery Center LLC

Palmetto Endoscopy Center