CPT code 58270: Vaginal hysterectomy, with enterocele repair2026 Medicare rate & RVUs in Missouri
Vaginal hysterectomy for a uterus weighing 250 g or less with concurrent repair of an enterocele, commonly performed for uterovaginal prolapse.
CMS doesn’t publish an office rate for 58270 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 58270 covers
This service combines removal of the uterus through the vagina with repair of an enterocele, a herniation of peritoneal tissue into the upper vagina. A gynecologic surgeon may perform it for uterovaginal prolapse when an enterocele also requires repair. The procedure is typically performed in a hospital or ambulatory surgery setting, rather than an office.
Report the code when the operative service includes both vaginal hysterectomy for a uterus weighing 250 g or less and enterocele repair. The operative report should document the vaginal route, the repair performed, and the uterine weight, supported by the pathology record when available. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; 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 58270 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $778.96 |
| Metropolitan St. Louis, MO | Unavailable | $783.86 |
| Rest of Missouri | Unavailable | $762.77 |
How the 58270 rate is calculated
Each of 58270’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 · 58270
RVUs × geographic indexes × conversion factor
Work14.92
14.92 RVUs× 1.000 GPCI
Practice expense6.19
6.19 RVUs× 1.000 GPCI
Malpractice2.65
2.65 RVUs× 1.000 GPCI
Adjusted RVUs
23.7600
Conversion factor
$33.4009
Medicare rate
$793.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58270
58270 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58270
Vaginal hysterectomy, with enterocele repair
| 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 · 58270
Vaginal hysterectomy, with enterocele repair
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
58270 without 51 · national facility
$793.61
Vaginal hysterectomy, with enterocele repair
58270-51 · Second procedure: 50%
$396.81
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%).
58270 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 58260Vaginal hysterectomyUterus 250 grams or less
- Both describe vaginal hysterectomy for a uterus weighing 250 g or less. Choose 58270 when an enterocele is repaired during the operation; 58260 does not include that repair.
- 58263Vaginal hysterectomyAdnexal removal and enterocele repair
- This code includes enterocele repair with the small-uterus vaginal hysterectomy. Code 58263 also includes removal of one or both tubes and/or ovaries.
- 58294Vaginal hysterectomyComplex with enterocele repair
- Both include enterocele repair with vaginal hysterectomy. Code 58270 is for a uterus weighing 250 g or less; 58294 is for a uterus weighing more than 250 g.
- 58267Vaginal hysterectomyCystocele repair, uterus ≤250 g
- Both are small-uterus vaginal hysterectomy codes with an added repair. Code 58270 includes enterocele repair, while 58267 includes urinary support repair.
58270 billing questions
When should this code be chosen over 58260?
Use 58270 when the vaginal hysterectomy for a uterus weighing 250 g or less includes repair of an enterocele. Code 58260 describes the vaginal hysterectomy without that repair.
Is the enterocele repair reported separately?
The repair is part of the combined service described by 58270. The operative documentation should show that the enterocele was repaired during the hysterectomy.
How does 58270 differ from 58263?
Code 58270 includes enterocele repair. Code 58263 applies when the hysterectomy also includes removal of one or both tubes and/or ovaries along with the repair.
What supports the selection of this code?
Document the vaginal route, the hysterectomy, the enterocele repair, and uterine weight of 250 g or less. The operative note and pathology record can support these details.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period is tied to the surgery, not to a separate billing of routine related follow-up.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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