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CPT 58750 Fee Schedule

Last Verified: November 2025

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

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$1071.001639476377 - LIVONIA OUTPATIENT SURGERY CENTER, LLC261322609 - (MI) LIVONIA OUTPATIENT SURGERY CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3357.001538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC205170962 - (CA) PHYSICIANS SURGERY CENTER OFCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2700.001649871450 - ADVANCED HEART AND VEIN SURGERY CENTER, LLC844546684 - (CO) ADVANCED HEART AND VEIN SURGERY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3350.001801974720 - SUMMIT SURGICAL CENTER, LLC731730859NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1224.001427017813 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PENINSULA ENDOSCOPY CENTER200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1991.001073509733 - WEST PLAINS SURGERY CENTER LLC320093110 - (MO) WEST PLAINS AMBULATORY SURGERY CENTMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2502.001609871847 - THE SURGERY CENTER, LLC582520623 - (GA) THE SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1369.001073757480 - ENDOSCOPY CENTER OF WESTERN COLORADO INC262645683COAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$3570.001689664906 - PEDIATRIC SURGERY CENTERS, LLC201711553FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2228.001114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$1339.001083837926 - HERITAGE EYE SURGERY CENTER, LLC, PRECISION VISION SURGERY CENTER731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC.OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$2703.001366041469 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA954373071CAAmbulatory 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$4339.001245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
58750$4339.001205945243 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER 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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