CPT 58565 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 52 - Reduced Services |
| Complexity Level | High |
National average reimbursement for CPT 58565 by major payers:
$2,040.90
$2,479.60
$2,338.30
$2,985.64
| 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 58565 | ||||||
United | 58565 | $3360.00 | 1750386322 - NOVAMED SURGERY CENTER OF COLORADO SPRINGS, LLC, PREMIER SURGERY CENTER | 731630170 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1800.00 | 1205184603 - ST. LUKES SURGICAL AT THE VILLAGES, INC | 460659691 - (FL) ST LUKES SURGICAL AT THE VILLAGES INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $3193.00 | 1710688627 - BAPTIST HEALTH SURGERY CENTER BRECKENRIDGE LLC | 922359229 - (KY) BAPTIST HEALTH SURGERY CENTER BRECKENRIDGE LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $4358.00 | 1306556907 - THE VANCOUVER CLINIC INC PS, SALMON CREEK 2 AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1473.00 | 1346878303 - HOT SPRINGS AMBULATORY SURGERY CENTER, LLC | 832533389 - (AR) HOT SPRINGS AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1200.00 | 1255792453 - MIDWEST EYE CONSULTANTS OHIO, INC, CATARACT & LASER INSTITUTE #351 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $733.13 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $5354.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1339.00 | 1215957816 - SURGERY CENTER OF CENTRAL VIRGINIA INC., D.B.A. EYE SURGERY CENTER | 541816412 - (VA) SURGERY CENTER OF CENTRAL VIRGINIA INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1000.00 | 1831349406 - GASTROENTEROLOGY EAST, P.A. | 202964888 - (NC) GASTROENTEROLOGY EAST, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $586.00 | 1306885256 - EYE SURGICAL CENTER, LLC, THE INSTITUTE FOR REFRACTIVE AND INTRAOCULAR SURGERY | 200318724 - (OH) EYE SURGICAL CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $3925.00 | 1598039125 - ROOSEVELT SURGERY CENTER, LLC | 271778024 - (NY) ROOSEVELT SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $2055.00 | 1821074485 - SURGERY CENTER OF FARMINGTON, L.L.C. | 431811835 - (MO) SURGERY CENTER OF FARMINGTON | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $7391.00 | 1598729329 - SURGICARE OF ST ANDREWS LTD | 611276561 - (FL) SURGICARE OF ST ANDREWS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58565 | $1579.00 | 1114907920 - MIAMI ASC LP, THE ENDOSCOPY CENTER | 621600424 - (FL) MIAMI ASC LP | FL | 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 58565 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58565 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 58565 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 | Hysteroscopy; W/ Biopsy Of Endometrium And/Or Polypectomy, W/Wo D&C |
| 58561-CPT | Moderate | Hysteroscopy, Surgical; W/ Removal Of Leiomyomata |
| 58565-CPT | High | Hysteroscopy, Surgical; With Bilateral Fallopian Tube Cannulcannulation To Induce Occlusion By Placement Of Permanent Im |
| 58600-CPT | Moderate | Transection Fallopian Tube |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58565. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58565 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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