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See a sample rate comparisonCPT 58561 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.
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.
| 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 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 58561 |
| Medicaid Fee Schedule | View Medicaid rates for 58561 |
National average reimbursement for CPT 58561 by major payers:
$550.76
$596.79
$649.74
$675.95
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CPT 58561
5 of 25 sample ratesHigher to lower in this preview
Reston Surgery Center, Lp
Reston Surgery Center Lp
$6,003.00Published ratePhysician'S Surgery Center Of Knoxville LLC
Physicians Surgery Center Of Knoxville LLC
$3,347.00Published rateArchibald Surgery Center, LLC
Archibald Surgery Center
$2,309.00Published rateFairfax Colon & Rectal Surgery Center, LLC
$1,689.00Published rateStanley Kristiansen
Deaconess Hospital Inc
$292.14Published rate
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See a sample payer proposalCPT 58561 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58561 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 58561 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 |
|---|---|---|
| 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. |
| 58560-CPT | Moderate | Remove Partition From Uterus, Exam Of The Uterus Through The Cervix With The Aid Of A Scope (Hysteroscope). The Procedure Removes An Abnormal Dividing Wall (Septum) That Has Formed In The Uterus. |
| 58561-CPT | Moderate | 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58561 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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