CPT code 58145: Myomectomy, vaginal approach2026 Medicare rate & RVUs in Florida
Reports surgical removal of uterine fibroid tissue through the vagina, commonly when a leiomyoma protrudes through the cervix.
CMS doesn’t publish an office rate for 58145 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 58145 covers
Code 58145 represents surgical removal of one or more uterine fibroids through the vagina while preserving the uterus. A typical situation is a leiomyoma that has prolapsed through the cervix into the vaginal canal and can be reached for excision. A gynecologist generally performs the operation in a hospital or ambulatory surgery setting.
Choose this code for the vaginal operative route, rather than an abdominal or laparoscopic approach. The operative report should identify the fibroid and describe the vaginal route and excision performed. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this single uterine procedure. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 58145 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $541.82 |
| Miami, FL | Unavailable | $582.62 |
| Rest of Florida | Unavailable | $517.41 |
How the 58145 rate is calculated
Each of 58145’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 58145
RVUs × geographic indexes × conversion factor
Work8.69
8.69 RVUs× 1.000 GPCI
Practice expense4.74
4.74 RVUs× 1.000 GPCI
Malpractice1.51
1.51 RVUs× 1.000 GPCI
Adjusted RVUs
14.9400
Conversion factor
$33.4009
Medicare rate
$499.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58145
58145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58145
Myomectomy, vaginal approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 58145
Myomectomy, vaginal approach
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58145 without 51 · national facility
$499.01
Myomectomy, vaginal approach
58145-51 · Second procedure: 50%
$249.51
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
58145 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 58140MyomectomyAbdominal, limited burden
- 58145 describes vaginal removal of fibroid tissue; 58140 is used for the abdominal approach.
- 58146MyomectomyComplex abdominal approach
- 58146 is an abdominal myomectomy code for more extensive fibroid removal. 58145 is selected for the vaginal route.
- 58545Laparoscopic myomectomyLimited fibroid burden
- 58545 describes laparoscopic myomectomy, while 58145 describes removal through the vagina.
- 58150HysterectomyAbdominal, cervix removed
- 58150 reports total hysterectomy, which removes the uterus; 58145 reports fibroid excision with the uterus preserved.
58145 billing questions
How is 58145 distinguished from abdominal myomectomy codes?
The defining factor is the operative route: 58145 is for vaginal excision. Abdominal myomectomy codes apply when the fibroid is removed through an abdominal incision.
Should modifier 50 be reported?
No. This is a single uterine procedure, not separate right- and left-sided work.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can another procedure be reported during the same session?
A separately performed procedure may be reported when supported, but the standard multiple-procedure reduction applies when multiple procedures are performed in the same session.
What documentation supports reporting 58145?
The operative report should identify the uterine fibroid and document that it was excised through the vaginal route.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 58145 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist