CPT 58554 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 58554 |
National average reimbursement for CPT 58554 by major payers:
$1,640.11
$1,761.84
$1,763.69
$2,168.32
| 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 58554 | ||||||
United | 58554 | $3537.00 | 1689605826 - LAUREL SURGERY & ENDOSCOPY CENTER, LLC | 412044822 - (MS) LAUREL SURGERY AND ENDOSCOPY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $2312.93 | 1316466774 - HASAN ALBITAR | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 58554 | $4865.00 | 1760533830 - GASTROINTESTINAL MEDICAL CENTER ASC | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $6189.00 | 1275682148 - TEMPLE UNIVERSITY HOSPITAL, INC | 232825878 - (PA) TEMPLE UNIVERSITY HOSPITAL INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $6492.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $2810.00 | 1770581829 - PHYSICIANS' SURGERY CENTER, LLC | 481217506 - (KS) PHYSICIANS SURGERY CENTER, L.L.C. | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $4189.00 | 1649735861 - KURESMART PAIN MANAGEMENT SURGERY CENTER-CATONSVILLE LLC, CLEARWAY SURGERY CENTER OF CATONSVILLE | 832414671 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCATONSVILLE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $6365.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $1821.00 | 1861497380 - NORTHEAST NEBRASKA SURGERY CENTER LLC, FAITH REGIONAL SURGERY CENTER | 470819088 - (NE) NORTHEAST NEBRASKA SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $5750.00 | 1346210259 - SURGICARE LLC | 351975122 - (IN) SURGICARE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $6588.00 | 1184687386 - DIGESTIVECARE, LLC, DIGESTIVECARE ENDOSCOPY UNIT | 311108485 - (OH) DIGESTIVE CARE, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $5851.00 | 1356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC | 842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $3474.00 | 1053560896 - ASC DEVELOPMENT COMPANY, LLC, NATIONAL SPINE AND PAIN CENTERS | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $5785.00 | 1447932769 - PRO SURGERY CENTER LLC | 931484998 - (WA) PRO SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58554 | $7229.00 | 1871032680 - OLIVE AMBULATORY SURGERY CENTER, LLC, NORTH CAMPUS SURGERY CENTER | 203834012 - (MO) OLIVE AMBULATORY SURGERY CENTER LLC | MO | 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 58554 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58554 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 58554 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 |
|---|---|---|
| 58553-CPT | High | Laparoscopy, Surgical, With Vaginal Hysterectomy, For Uterus Greater Than 250 Grams |
| 58554-CPT | High | Laparoscopy Surgical With Vaginal Hysterectomy For Uterus Greater Than 250 Grams; With Removal Of Tube(S) And/Or Ovary(S) |
| 58570-CPT | Moderate | Laparoscopy, Surgical, With Total Hysterectomy, For Uterus 250g Or Less; Once Per Dos |
| 58571-CPT | High | Laparoscopy Surgical With Total Hysterectomy For Uterus 250 G 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 58554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58554 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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