CPT 58956 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 • 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58956 |
National average reimbursement for CPT 58956 by major payers:
$1,676.86
$1,821.35
$1,829.34
$2,270.11
| 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 58956 | ||||||
United | 58956 | $597.00 | 1265462881 - WOOSTER OPHTHALMOLOGISTS, INC., EYE SURGERY CENTER OF WOOSTER | 341338984 - (OH) WOOSTER OPHTHALMOLOGISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $1559.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $1049.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $690.00 | 1295700086 - WESTERN WASHINGTON ENDOSCOPY CENTERS, LLC | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $507.00 | 1053058255 - INDIANA VASCULAR SURGERY CENTER LLC | 871608290 - (IN) INDIANA VASCULAR SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $544.00 | 1467016055 - HARBIN CLINIC, LLC, HARBIN CLINIC GI LAB CARTERSVILLE | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $559.00 | 1942306816 - OMEGA SURGERY CENTER LLC | 470821405 - (NE) OMEGA SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $780.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $120.00 | 1376657890 - SURGICAL SPECIALTY SUITES, INC | 61784797 - (MD) SURGICAL SPECIALTY SUITES INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $329.00 | 1891951885 - MISSISSIPPI EYE SURGERY CENTER, MISSISSIPPI EYE SURGERY CENTER FACILITY | 770619942 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $565.00 | 1184978637 - INLAND VALLEY SURGERY CENTER, LLC | 263900973 - (CA) INLAND VALLEY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $525.00 | 1528206141 - HATTIESBURG EYE CLINIC CATARACT & LASIK SURGERY CENTER, LLC | 200379151 - (MS) HATTIESBURG EYE CLINIC CATARACT LASIK SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $400.00 | 1750414983 - ROCKLEDGE SURGERY CENTER, INC. | 522098503 - (MD) ROCKLEDGE SURGERY CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $713.00 | 1174030878 - STUART SURGERY CENTER, LLC | 822542219 - (FL) STUART SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58956 | $461.00 | 1639566318 - TRIAD SURGERY CENTER, LLC | 473510624 | OK | 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 58956 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58956 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 58956 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 58956. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58956 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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