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CPT code 58294: Vaginal hysterectomy, complex with enterocele repair2026 Medicare rate & RVUs

Reports vaginal removal of a uterus weighing more than 250 grams when the operation also includes repair of an enterocele.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,069.50 for 58294 nationally in a facility.

Medicare rate · 58294

Vaginal hysterectomy, complex with enterocele repair

Office or facility?

Work RVUs
21.01
Total RVUs
32.02
Global days
090

National rate · 2026

$1,069.50

Facility setting, before claim adjustments.

See every locality for 58294 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 58294 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 58294 covers

A gynecologic surgeon removes the uterus through the vagina and repairs an enterocele, a protrusion of peritoneal contents into the upper vaginal area. This combination may be performed for uterine enlargement with pelvic organ prolapse. The operative report should identify the vaginal route, uterine weight, and the enterocele repair performed; document any additional procedures separately according to their operative work.

Select this code when the documented uterine weight is greater than 250 grams and the operation includes the enterocele repair. The repair is part of the combined service described by the code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. 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 58294 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

58294 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$985.55
AlaskaUnavailable$1,381.10
ArizonaUnavailable$1,044.21
ArkansasUnavailable$975.36
Atlanta, GAUnavailable$1,100.23
Austin, TXUnavailable$1,071.09
Bakersfield, CAUnavailable$1,058.27
Baltimore area, MDUnavailable$1,127.73
Beaumont, TXUnavailable$1,038.74
Brazoria, TXUnavailable$1,045.87

58294 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
58294 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 58294 rate is calculated

Each of 58294’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 · 58294

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.01

21.01 RVUs× 1.000 GPCI

Practice expense7.33

7.33 RVUs× 1.000 GPCI

Malpractice3.68

3.68 RVUs× 1.000 GPCI

Adjusted RVUs

32.0200

Conversion factor

$33.4009

Medicare rate

$1,069.50

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 58294

58294 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58294

Vaginal hysterectomy, complex with enterocele repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.12/0.74/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 58294

Vaginal hysterectomy, complex 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

58294 without 51 · national facility

$1,069.50

Vaginal hysterectomy, complex with enterocele repair

58294-51 · Second procedure: 50%

$534.75

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%).

When to use modifier 51

58294 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 58294

    Vaginal hysterectomy, complex with enterocele repair21.01 wRVU

    Not priced

  • 58270

    Vaginal hysterectomy, with enterocele repair14.92 wRVU

    Not priced

  • 58290

    Vaginal hysterectomy, uterus over 250 grams19.76 wRVU

    Not priced

  • 58291

    Vaginal hysterectomy, complex, with tube or ovary removal21.51 wRVU

    Not priced

How to choose

58270Vaginal hysterectomyWith enterocele repair
Use 58270 when the uterus weighs 250 grams or less and the vaginal hysterectomy includes enterocele repair; this code is for a uterus over 250 grams.
58290Vaginal hysterectomyUterus over 250 grams
Both describe vaginal hysterectomy for a uterus over 250 grams. This code also includes enterocele repair, while 58290 does not.
58291Vaginal hysterectomyComplex, with tube or ovary removal
Choose 58291 when removal of tube(s) and/or ovary(s) is part of the larger-uterus vaginal hysterectomy; use this code when the defining additional service is enterocele repair.

Codes related to 58294

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 58294
CodeHow it relatesNational office range
Same family
58270Vaginal hysterectomy, with enterocele repairVaginal hysterectomy with enterocele repair for a uterus weighing 250 grams or less.No office rate
58290Vaginal hysterectomy, uterus over 250 gramsVaginal hysterectomy for a uterus weighing more than 250 grams without the added enterocele repair.No office rate
58291Vaginal hysterectomy, complex, with tube or ovary removalLarger-uterus vaginal hysterectomy variant that includes removal of tube(s) and/or ovary(s).No office rate
58260Vaginal hysterectomy, uterus 250 grams or lessVaginal hysterectomy for a uterus weighing 250 grams or less, without the added repair.No office rate

58294 billing questions

How does this differ from 58270?

Both include vaginal hysterectomy with enterocele repair. Code 58270 is for a uterus weighing 250 grams or less; this code is for a uterus weighing more than 250 grams.

Can the enterocele repair be reported separately?

The enterocele repair is included in this combined service. Do not separately report that same repair as an additional procedure.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What documentation supports selecting this code?

The operative report should establish the vaginal approach, uterine weight greater than 250 grams, and the enterocele repair performed.

How is assistant or co-surgeon involvement handled?

Assistant-at-surgery payment may be made. 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

Show the CMS file lines behind this rate
RVUs for 58294PPRRVU2026_Oct_nonQPP.csv, line 6,539 (RVU26D)

Open CMS sourceHow we calculate rates

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