CPT 58954 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 • 22 - Increased Procedural Services • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 58954 by major payers:
$2,736.21
$2,883.07
$2,968.40
$3,583.68
| 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 58954 | ||||||
United | 58954 | $2812.00 | 1093088999 - CHIPPENHAM AMBULATORY SURGERY CENTER, LLC | 371587067 - (VA) CHIPPENHAM AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $1775.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $773.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $690.00 | 1790744175 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PUYALLUP ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $1145.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $995.00 | 1760533830 - GASTROINTESTINAL MEDICAL CENTER ASC | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $1000.00 | 1124612924 - MILWAUKEE SURGICENTER LLC | 854072458 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $712.00 | 1033177373 - SURGICARE OF LA VETA LTD, LAVETA SURGERY CENTER | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $100.00 | 1275725673 - GASTROENTEROLOGY CONSULTANTS OF TUSCALOOSA INC, TUSCALOOSA ENDOSCOPY CENTER | 630892558 | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $406.00 | 1205454626 - EYE SURGERY CENTER OF WISCONSIN, LLC | 833779684 - (WI) EYE SURGERY CENTER OF WISCONSIN, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $115.00 | 1447220082 - WESTERN PA SURGERY CENTER, WEXFORD BRANCH, LLC, WESTERN PA SURGERY CENTER | 251826912 - (PA) WESTERN PA SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $4115.00 | 1144612714 - ANCHORAGE SURGICENTER, LLC | 472881055 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $600.00 | 1184689408 - EVERGREEN EYE CENTER, PLLC, EYE ASSOCIATES NORTHWEST SURGERY CENTER | 911610832 - (WA) EYE ASSOCIATES NORTHWEST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $1348.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58954 | $927.00 | 1508851213 - FROEDTERT SURGERY CENTER, LLC | 201499345 - (WI) FROEDTERT SURGERY CENTER, LLC | WI | 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 58954 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58954 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 58954 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 |
|---|---|---|
| 58953-CPT | High | Bilateral Salpingo-Oophorectomy With Omentetomy, Total Abdominal Hysterectomy And Radical Dissection For Debulking; |
| 58954-CPT | High | Bilateral Salpingo-Oophorectomy With Omentectomy, Total Abdominal Hysterectomy And Radical Dissection For Debulking; With Pelvic Lymphadenectomy And Limited Para-Aortic Lymphadenectomy |
| 58956-CPT | High | Bilateral Salpingo-Oophorectomy With Total Omentectomy, Total Abdominal Hysterectomy For Malignancy |
| 58957-CPT | High | Resection (Tumor Debulking) Of Recurrent Ovarian Tubal Primary Peritoneal Uterine Malignancy (Intra-Abdominal Retroperitoneal Tumors) With Omentectomy If Performed; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58954. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58954 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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