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 |
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 | $1546.00 | 1780865634 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND TERAPEUTIC CENTER | 205904604 | LA | 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 | $800.00 | 1528024114 - AMBULATORY CARE CENTER PA | 223479837 - (NJ) AMBULATORY CARE CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1563.00 | 1083601298 - LAHAYE CENTER FOR ADVANCED EYE CARE, APMC, LAHAYE EYE CLINIC | 720988221 - (LA) LAHAYE EYE CLINIC, P.C. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2195.00 | 1417217183 - PAULSEN STREET SUGERY CENTER LLC | 824075002 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1501.00 | 1588667208 - BRADFORD PARKWAY SURGERY AND LASER CENTER | 20562180 - (MO) BRADFORD PARKWAY SURGERY AND LASER CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1792.00 | 1740771708 - EAST FORT LAUDERDALE ASC LLC, FT. LAUDERDALE HEART & RHYTHM SURGERY CENTER | 821945127 - (FL) EAST FORT LAUDERDALE ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1500.00 | 1376716316 - CPM SURGERY CENTER LLC | 261382311 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $3500.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2490.00 | 1912158684 - SURGCENTER OF BEL AIR | 262215322 - (MD) SURGCENTER OF BEL AIR, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1250.00 | 1760658256 - HARVARD SURGERY CENTER LLC | 208147301 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1763.00 | 1215185335 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $2010.00 | 1194323725 - MISSION SURGERY CENTER LLC | 853429411 - (TX) MISSION SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $3507.00 | 1366449571 - SHORE OUTPATIENT SURGICENTER LLC | 582252127 - (NJ) SHORE OUTPATIENT SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58943 | $1114.00 | 1255809620 - PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | 208397360 - (NE) PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | NE | 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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