CPT 58552 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 • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58552 |
National average reimbursement for CPT 58552 by major payers:
$1,175.37
$1,317.45
$1,354.66
$1,631.78
| 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 58552 | ||||||
United | 58552 | $3974.00 | 1265851034 - HANCOCK PARK SURGERY CENTER, LLC | 465306378 - (CA) HANCOCK PARK SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $1692.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $6492.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $2585.00 | 1316290380 - ATHENS SURGERY CENTER LLC, THE SURGERY CENTER OF ATHENS | 800812776 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $4800.00 | 1396089108 - TRIANGLE ORTHOPAEDICS SURGERY CENTER | 275268935 - (NC) TRIANGLE ORTHOPAEDICS SURGERY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $2798.00 | 1437138500 - CONCORD EYE SURGERY LLC | 20522032 - (NH) CONCORD EYE SURGERY LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $793.25 | 1467042804 - MARIA KLOPFENSTEIN | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 58552 | $5851.00 | 1760421846 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE EVERETT BONE AND JOINT SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $6303.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $4234.00 | 1992037352 - BAYLOR SURGICARE AT MANSFIELD, LLC, BAYLOR SCOTT & WHITE SURGICARE - MANSFIELD | 271835675 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $4914.00 | 1992058325 - SOUTH BEND SPECIALTY SURGERY CENTER, LLC | 460571418 - (IN) SOUTH BEND SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $2459.00 | 1255345229 - BEACON ORTHOPAEDICS SURGERY CENTER, LLC, SUMMIT SURGERY CENTER | 311800570 - (OH) BEACON ORTHOPAEDICS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $1760.00 | 1881699106 - CENTER FOR DAY SURGERY | 621845006 - (TN) CENTER FOR DAY SURGERY | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $5330.00 | 1932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER | 223777533 - (NJ) MAY STREET SURGI CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58552 | $3000.00 | 1497942460 - ORTHOPAEDIC SURGERY CENTER OF ASHEVILLE, LP, OUTPATIENT SURGERY CENTER OF ASHEVILLE | 621843091 - (NC) ORTHOPAEDIC SURGERY CENTER OF ASHEVILLE LP | NC | 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 58552 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58552 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 58552 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 |
|---|---|---|
| 58180-CPT | High | Supracervical Abdominal Hysterectomy (Subtotal Hysterectomy), With Or Without Removal Of Tube(S), With Or Without Removal Of Ovary(S) |
| 58267-CPT | High | Vaginal Hysterectomy, For Uterus 250 G Or Less; With Colpo-Urethrocystopexy (Marshall-Marchetti-Krantz Type, Pereyra Type) With Or Without Endoscopic Control |
| 58294-CPT | High | Vaginal Hysterectomy, For Uterus Greater Than 250 Grams With Repair Of Enterocele |
| 58552-CPT | High | Laparoscopy, Surgical, With Vaginal Hysterectomy, For Uterus 250 Grams Or Less; With Removal Of Tube(S) And/Or Ovary(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58552 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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