CPT 58960 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 • 80 - Assistant surgeon • AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 58960 |
National average reimbursement for CPT 58960 by major payers:
$1,257.82
$1,285.51
$1,291.32
$1,630.24
| 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 58960 | ||||||
United | 58960 | $3145.00 | 1306043617 - UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $5040.00 | 1700492170 - MERCY HEALTH BOARDMAN SURGERY | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $2400.00 | 1255676920 - NORTHPOINTE SURGICAL CENTER, LLC | 461487986 - (UT) NORTHPOINTE SURGICAL CENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $5963.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $3633.00 | 1639456973 - PHYSICIAN SURGERY CENTER OF ALBUQUERQUE LLC, POSC OF ABQ LLC | 273193930 - (NM) PHYSICIAN SURGERY CENTER OF ALBUQUERQUE LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $2703.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $1588.00 | 1629032446 - AMBULATORY SURGERY CENTER GROUP LTD | 592073099 - (FL) AMBULATORY SURGERY CENTER GROUP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $2912.00 | 1346243680 - LAWRENCE SURGERY CENTER LLC | 481212136 - (KS) LAWRENCE SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $795.00 | 1033250618 - MCDOWELL AMBULATORY SURGERY CENTER LLC | 261184708 - (AZ) MCDOWELL AMBULATORY SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $5500.00 | 1972153997 - EASTERN PENNSYLVANIA ENDOSCOPY CENTER, LLC | 842257961 - (PA) EASTERN PENNSYLVANIA ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $1751.00 | 1306877261 - NORTHEAST ALABAMA EYE SURGERY CENTER, NORTHEAST AL EYE SURGERY | 631277373 - (AL) NORTHEAST ALABAMA EYE SURGERY CENTER | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $2228.00 | 1184814782 - PUNXSUTAWNEY AREA HOSPITAL INC | 250965210 - (PA) PUNXSUTAWNEY AREA HOSPITAL INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $3000.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $6436.00 | 1548870603 - DURANGO SURGERY CENTER LLC, ANIMAS SURGICAL CENTER AT ESCALANTE | 851267666 - (CO) DURANGO SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 58960 | $2962.00 | 1972923068 - TRUECARE SURGERY CENTER, LLC | 463892733 - (CA) TRUECARE SURGERY CENTER LLC | CA | 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 58960 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 58960 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 58960 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 |
| 58960-CPT | High | Laparotomy, For Staging Or Restaging Of Ovarian, Tubal, Or Primary Peritoneal Malignancy (Second Look), With Or Without Omentectomy, Peritoneal Washing, Biopsy Of Abdominal And Pelvic Peritoneum, Diaphragmatic Assessment With Pelvic And Limited Para-Aortic Lymphade |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 58960. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 58960 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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