CPT 58943 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58943 |
National average reimbursement for CPT 58943 by major payers:
$1,415.26
$1,553.01
$1,562.90
$1,958.15
| 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 58943 | ||||||
United | 58943 | $1900.00 | 1629313739 - COLTON CA MULTI ASC LP, PREMIER OUTPATIENT SURGERY CENTER | 461462978 - (CA) COLTON CA MULTI ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $796.00 | 1467472688 - WEST CLINIC ASTC, WEST CLINIC, PC | 621526296 - THE WEST CLINIC, PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $3629.00 | 1316072234 - ARIA HEALTH SYSTEM, ARIA HEALTH FRANKFORD CAMPUS SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1512.00 | 1174586606 - BELLEAIR SURGERY CENTER LTD | 742544710 - (FL) BELLEAIR SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1250.00 | 1760658256 - HARVARD SURGERY CENTER LLC | 208147301 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $6342.00 | 1619093218 - CLEBURNE SURGICAL CENTER, LLC | 203742012 - (TX) CLEBURNE SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2363.00 | 1073713004 - ADVANCED EYE SURGERY CENTER | 205045500 - (CA) ADVANCED EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $3422.00 | 1639452444 - CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC | 271462884 - (NJ) CHILDRENS AMBULATORY SURGERY CENTER OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $3470.00 | 1104990050 - FOUR CORNERS AMBULATORY SURGERY CENTER, LLC | 911798298 - (NM) FOUR CORNERS AMBULATORY SURGERY CENTER, LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $4143.10 | 1609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC | 831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1500.00 | 1982745568 - NORTHWEST SURGERY CENTER, INC | 911405577 - (WA) NORTHWEST SURGERY CENTER INC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2715.00 | 1962568725 - BRECKENRIDGE SURGERY CENTER LP | 201177785 - (TX) BRECKENRIDGE SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1550.00 | 1033115472 - CAPLAN-BERKELEY, LLP, CAPLAN SURGERY CENTER | 571146952 - (TX) CAPLANBERKELEY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2900.00 | 1164723011 - SURGICAL SPECIALTY CENTER OF WESTCHESTER LLC, PLASTIC SURGERY CENTER OF WESTCHESTER LLC | 273453889 - (NY) SURGICAL SPECIALTY CENTER OF WESTCHESTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1618.00 | 1356903967 - UNITY LINDEN OAKS SURGERY CENTER | 800798208 | NY | 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 58943 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58943 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 58943 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 |
|---|---|---|
| 58825-CPT | Moderate | Transposition, Ovary(S) |
| 58920-CPT | Moderate | Wedge Resec/Bisection-Ovary,Uni/Bil |
| 58940-CPT | Moderate | Oophorectomy,Part/Total,Uni/Bilat; |
| 58943-CPT | High | Oophorectomy Partial Or Total Unilateral Or Bilateral; For Ovarian Tubal Or Primary Peritoneal Malignancy With Para- Aortic And Pelvic Lymph Node Biopsies Peritoneal Washings Peritoneal Biopsies Diaphragmatic Assessments With Or Without Salpingectomy(S) With Or Without Omentectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58943. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58943 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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