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See a sample rate comparisonCPT 58555 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Hysteroscopy, Diagnostic (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Female Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 58555 |
| Medicaid Fee Schedule | View Medicaid rates for 58555 |
National average reimbursement for CPT 58555 by major payers:
$377.12
$392.96
$461.35
$283.61
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CPT 58555
5 of 25 sample ratesHigher to lower in this preview
Elizabeth Small-Pal
Mass General Brigham Incorporated
$1,547.78Published rateAnthony Agrios
Florida Woman Care, LLC
$574.30Published rateTiffany Vuong
Town Center Orthopaedic Associates, P.C.
$460.92Published rateLisa Pagel
Deaconess Hospital Inc
$237.58Published rateChristopher Raio
Mercy Medical Center
$135.16Published rate
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See a sample payer proposalCPT 58555 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58555 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 58555 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 |
|---|---|---|
| 58555-CPT | Moderate | Hysteroscopy, Diagnostic (Separate Procedure) |
| 58558-CPT | High | Scope Surgery Of Uterus, Surgery On The Uterus Aided By A Scope (Hysteroscopy). The Procedure May Take A Sample Of Tissue For Testing (Biopsy). Alternatively The Procedure Removes The Uterus Lining Or Growths Such As Polyps Tumors Or Fibroids. |
| 58559-CPT | Moderate | Remove Scar Tissue From Uterus, An Exam Of The Uterus With A Scope (Hysteroscope) Inserted Through The Cervix. The Procedure Cuts Scar Tissue Inside The Uterus. |
| 58570-CPT | Moderate | Hysterectomy With Laparoscope, Surgery Aided By A Scope (Laparoscope) To Remove The Uterus (Hysterectomy). One Or Both Pairs Of Fallopian Tubes Or Ovaries Also May Be Removed. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58555 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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