How can I find out the cost of a medical procedure?

The cost of medical procedures can vary significantly based on the provider, location, and your insurance plan. To get an estimate for a specific procedure, especially if you know the CPT code and your specific location, you can use specialized tools. For instance, Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to get pricing information. You should also always contact your insurance provider and the healthcare facility directly for the most accurate and personalized quote for your situation.

What is a CPT code and why is it important for pricing?

CPT stands for Current Procedural Terminology. CPT codes are a standardized set of five-digit codes used by healthcare professionals to describe medical, surgical, and diagnostic services provided to patients. They are crucial for billing and reimbursement processes, as they help insurance companies and patients understand the specific services rendered. When looking up the cost of a procedure, knowing the CPT code can help you get a more precise price estimate, as these codes are often linked to specific fee schedules.

Where can I find fee schedules for medical services?

Fee schedules for medical services can be complex and are often negotiated privately between healthcare providers and insurance companies. However, for users looking to research potential costs, tools exist that aggregate and display this information. For example, Payerprice offers a fee schedule lookup tool where you can search using a CPT code and your specific location to find relevant pricing data. Additionally, your insurance provider can often provide you with an explanation of benefits or an estimate based on your specific plan and network providers.

How do I compare prices for healthcare services in my area?

Comparing prices for healthcare services requires specific information, such as the CPT code for the service you need and your geographic location. To facilitate this comparison, you can utilize online resources designed for price transparency. Payerprice, for example, provides a fee schedule lookup tool that allows you to input a CPT code and location to compare potential costs. It's also recommended to contact multiple healthcare providers and your insurance company directly to obtain detailed quotes and understand your out-of-pocket expenses.

I need to know the exact cost for a specific medical service with a known CPT code. Where should I look?

To find the exact cost for a specific medical service when you have the CPT code, the most direct approach is to use a specialized fee schedule lookup tool. Payerprice offers such a tool that enables users to search with a CPT code and their specific location to retrieve detailed pricing information. While these tools provide valuable estimates, always confirm the final cost with your healthcare provider and insurance company, as your individual plan benefits and deductibles will impact your out-of-pocket expense.

CPT 58563 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.

Scope Surgery Of Uterus, Surgery On The Uterus Aided By A Scope (Hysteroscopy). The Procedure Includes Removing The Lining Of The Uterus Or Growths Such As Polyps Tumors Or Fibroids. Tissue Samples May Also Be Taken For Testing (Biopsy).

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 51 - Multiple procedures AG - Primary physician
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 58563
Medicaid Fee Schedule	View Medicaid rates for 58563

National average reimbursement for CPT 58563 by major payers:

$2,099.51

$2,451.38

$2,766.32

$713.45

Compare published rates across providers.

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CPT 58563

5 of 25 sample ratesHigher to lower in this preview

Alaska Surgery Center, Limited Partnership
Alaska Surgery Center Limited Partnership
AKAmbulatory Surgical Clinic/CenterNPI 1205892197Tax ID 93-0982396
$9,558.00Published rate
Haymarket Surgery Center, LLC
Haymarket Surgery Center
VAAmbulatory Surgical Clinic/CenterNPI 1952749491Tax ID 46-2874962
$3,570.00Published rate
St. Vincent'S Outpatient Surgery Services LLC
St Vincents Outpatient Surgery Services LLC
ALAmbulatory Surgical Clinic/CenterNPI 1972805299Tax ID 20-0708162
$2,699.00Published rate
Ascent Surgery Center, LLC
Ascent Surgery Center LLC
OHAmbulatory Surgical Clinic/CenterNPI 1619559044Tax ID 85-3327359
$1,400.00Published rate
Arizona Skin Cancer Surgery Center, P.C.
Arizona Skin Cancer Surgery Center PC
AZAmbulatory Surgical Clinic/CenterNPI 1518969773Tax ID 56-2365590
$630.00Published 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 58563 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 58563 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 58563 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.
58563-CPT	High	Scope Surgery Of Uterus, Surgery On The Uterus Aided By A Scope (Hysteroscopy). The Procedure Includes Removing The Lining Of The Uterus Or Growths Such As Polyps Tumors Or Fibroids. Tissue Samples May Also Be Taken For Testing (Biopsy).

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58563. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 58563 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 58563 Fee Schedule

Alaska Surgery Center, Limited Partnership

Haymarket Surgery Center, LLC

St. Vincent'S Outpatient Surgery Services LLC

Ascent Surgery Center, LLC

Arizona Skin Cancer Surgery Center, P.C.