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CPT 58750 Fee Schedule

Last Verified: January 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.

Tubotubal Anastomosis
Key FactDetail
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

50 - Bilateral Procedure

RT - Right side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 58750

National average reimbursement for CPT 58750 by major payers:

bcbs

$1,202.70

uhc

$1,227.06

aetna

$1,242.63

cigna

$1,512.70

Preview provider-level rates for...
For billing codeCPT 58750
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 58750

United
58750$6026.001871575043 - AMBULATORY SURGERY CENTER OF COOL SPRINGS LLC, VANDERBILT SURGERY CENTER COOL SPRINGS621809227 - (TN) AMBULATORY SURGERY CENTER OF COOL SPRINGS LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2700.001548870603 - DURANGO SURGERY CENTER LLC, ANIMAS SURGICAL CENTER AT ESCALANTE851267666 - (CO) DURANGO SURGERY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3623.001821036138 - GAMMA SURGERY CENTER LLC270128900 - (PA) GAMMA SURGERY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$6399.001699702050 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON BELLEVUE ASC910565539 - (WA) VIRGINIA MASON MEDICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3623.001093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER454307241AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3623.001144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2300.001760808836 - OVERLAKE REPRODUCTIVE HEALTH INC PS., OVERLAKE REPRODUCTIVE HEALTH INC.- AMBULATORY SURGICAL FACILITY911796570 - (WA) OVERLAKE REPRODUCTIVE HEALTH, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1500.001295258416 - PUMPKIN PATCH AMBULATORY SURGICAL CENTER, LLC, ORLANDO AVENUE SURGERY CENTER, LLC475078896 - (FL) PUMPKIN PATCH AMBULATORY SURGICAL CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$727.001386277069 - SOUTHWEST ENDOSCOPY LLC261261804AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2081.001760931349 - SF NASSAU ASC LLC300870382 - (NY) SF NASSAU ASC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1200.001306320338 - ALABAMA EYE SURGERY CENTER LLC814662532 - (AL) ALABAMA EYE SURGERY CENTER LLCALAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$6602.001740236454 - PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT LLC, PRINCESS ANNE AMBULATORY SURGERY CENTER204920880 - (VA) PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT, LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3350.001801974720 - SUMMIT SURGICAL CENTER, LLC731730859NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1490.001609882810 - LAGRECA EYE CLINIC PC, THE EYE CLINIC SURGICENTER LAGRECA EYE CLINIC320016290 - LAGRECA EYE CLINIC, PCMTAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1697.001801458989 - MILLENNIUM SURGERY CENTERS OF FLORIDA, LLC371911799 - (FL) MILLENNIUM SURGERY CENTERS OF FLORIDA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 58750 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 58750 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 58750 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.

CodeComplexityDescription
58700-CPTModerateSalpingectomy Unilat/Bilat
58720-CPTModerateSalp-Oophorec,Complt/Part,Unil/Bil
58740-CPTHighSalpingolysis/Ovariolysis
58750-CPTHighTubotubal Anastomosis

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 58750 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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