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CPT code 58555: Hysteroscopy, diagnostic only2026 Medicare rate & RVUs in Vermont

Reports hysteroscopic inspection of the uterine cavity for diagnostic evaluation when no biopsy, tissue removal, or other operative hysteroscopic service is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality1.2K Medicare services in 2024

In Vermont, Medicare pays $318.30 for 58555 in the office and $126.85 when it’s performed in a hospital or facility.

$318.30Office (non-facility)
$126.85Hospital or facility
−3.0%vs the national office rate ($328.00)

Check a contract rate as a % of Medicare · 58555 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 58555 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 58555 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 58555 covers

A gynecologist passes a hysteroscope through the cervix to inspect the endometrial cavity, for example when evaluating abnormal uterine bleeding or a suspected intracavitary abnormality. The procedure may be performed in an office or outpatient surgical setting. This code represents diagnostic visualization, not hysteroscopic sampling or treatment of a finding.

Report it when diagnostic inspection is the hysteroscopic service performed; document the indication, findings, and whether any operative work was done. Because it is a separate procedure, diagnostic inspection is generally not separately reported when it is part of a hysteroscopic biopsy or treatment. The 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced by 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, while 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.

How Vermont compares for 58555

Across 109 of 109 payment localities, the office rate for 58555 runs from $288.73 in Arkansas to $430.74 in San Benito County, CA. Vermont pays $318.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

58555 in Vermont vs other payment areas
  1. Vermont · this page$318.30
  2. Los Angeles, CA · California$367.98+$49.68
  3. Washington, DC area · District of Columbia$374.72+$56.42
  4. Miami, FL · Florida$360.28+$41.98
  5. Chicago, IL · Illinois$349.20+$30.90
  6. Manhattan, NY · New York$379.06+$60.76
  7. Alaska · Alaska$379.08+$60.78

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

58555 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$293.12$123.91
ArkansasArkansas$288.73$122.61
ArizonaArizona$318.80$131.41
Bakersfield, CACalifornia$345.53$133.57
Chico, CACalifornia$344.26$132.30
El Centro, CACalifornia$344.33$132.38
Fresno, CACalifornia$344.26$132.30
Hanford, CACalifornia$344.26$132.30

58555 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

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

$288.73

$387.50

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
58555 office rate range by state
State / territoryOffice rate rangeLocalities
AK$379.081
AL$293.121
AR$288.731
AZ$318.801
CA$344.26–$430.7429
CO$340.251
CT$350.341
DC$374.721
DE$324.191
FL$325.58–$360.283
GA$306.39–$334.912
GU$352.741
HI$352.741
IA$299.661
ID$301.931
IL$316.73–$349.204
IN$303.721
KS$298.771
KY$301.551
LA$301.28–$316.662
MA$338.34–$373.872
MD$330.35–$374.723
ME$304.17–$320.412
MI$310.20–$330.372
MN$323.991
MO$296.31–$317.143
MS$292.551
MT$327.971
NC$307.381
ND$319.071
NE$301.181
NH$335.421
NJ$353.77–$370.732
NM$312.191
NV$325.711
NY$312.19–$389.265
OH$308.391
OK$300.381
OR$322.63–$350.702
PA$308.57–$341.752
PR$330.271
RI$335.501
SC$308.511
SD$318.021
TN$300.401
TX$306.52–$339.618
UT$312.861
VA$319.72–$374.722
VI$330.271
VT$318.301
WA$337.54–$381.042
WI$308.071
WV$304.771
WY$324.091

See 58555 in every payment locality

How the 58555 rate is calculated

Each of 58555’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 · 58555

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.58

2.58 RVUs× 1.000 GPCI

Practice expense6.79

6.79 RVUs× 1.000 GPCI

Malpractice0.45

0.45 RVUs× 1.000 GPCI

Adjusted RVUs

9.8200

Conversion factor

$33.4009

Medicare rate

$328.00

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

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,566

Code
58555
Physician work
2.58
Practice expense
6.79
Malpractice
0.45

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 58555 in Vermont
ComponentRVULocality factorAdjusted
Physician work2.58× 1.0002.5800
Practice expense6.79× 0.9906.7221
Malpractice0.45× 0.5060.2277
Total RVUs9.5298
Conversion factor× 33.4009

Office rate, Vermont$318.30

Office: (2.58 × 1 + 6.79 × 0.99 + 0.45 × 0.506) × $33.4009 = $318.30

Facility: (2.58 × 1 + 1 × 0.99 + 0.45 × 0.506) × $33.4009 = $126.85

Open 58555 in the RVU calculator

Payment rules and modifiers for 58555

The CMS indicators that decide how 58555 is paid alongside other services.

CMS payment indicators · 58555

Hysteroscopy, diagnostic only

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not paid without supporting documentation.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

58555 without 51 · national office

$328.00

Hysteroscopy, diagnostic only

58555-51 · Second procedure: 50%

$164.00

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

Codes related to 58555

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

Codes related to 58555
CodeHow it relatesOffice range, Vermont
Used instead
58558Hysteroscopy, biopsy or polyp removalUse for hysteroscopy that includes endometrial sampling or biopsy rather than diagnostic inspection alone.$1,246.92
58559Hysteroscopy, intrauterine adhesion lysisDescribes hysteroscopic treatment of intrauterine adhesions.No office rate
58560Hysteroscopy, uterine septum resectionDescribes hysteroscopic resection of a uterine septum.No office rate
58561Myoma removal, hysteroscopic approachDescribes hysteroscopic removal of uterine myomas.No office rate
58562Hysteroscopy, foreign-body removalDescribes hysteroscopic removal of a foreign body from the uterus.$384.80
58563Hysteroscopy, endometrial ablationDescribes hysteroscopic endometrial ablation rather than diagnostic inspection.$1,977.82

How 58555 has changed in Vermont

58555 · Office / nonfacility

$318.30

Effective 2026-10-01

The base rate is $1.74 lower than on 2025-10-01, moving from $320.04 to $318.30 (0.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $320.04changed to$318.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.65 changed to 2.58
    • Practice expense RVU 7.05 changed to 6.79
    • Malpractice RVU 0.47 changed to 0.45
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $351.97changed to$320.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.75 changed to 7.05
    • Malpractice RVU 0.44 changed to 0.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $346.23changed to$351.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $364.13changed to$346.23

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.88 changed to 7.75
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $378.14changed to$364.13

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.03 changed to 7.88
    • Malpractice RVU 0.42 changed to 0.44
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $365.41changed to$378.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.57 changed to 8.03
    • Malpractice RVU 0.43 changed to 0.42

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $329.64changed to$365.41

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.19 changed to 7.57
    • Malpractice RVU 0.42 changed to 0.43
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $300.84changed to$329.64

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.42 changed to 6.19
    • Malpractice RVU 0.33 changed to 0.42
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $271.43changed to$300.84

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.63 changed to 5.42
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $270.27changed to$271.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $311.25changed to$270.27

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.33 changed to 2.65
    • Practice expense RVU 5.07 changed to 4.63
    • Malpractice RVU 0.40 changed to 0.32
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $304.45changed to$311.25

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.83 changed to 5.07
    • Malpractice RVU 0.43 changed to 0.40

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $302.93changed to$304.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $302.78changed to$302.93

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.76 changed to 4.83
    • Malpractice RVU 0.54 changed to 0.43
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$302.78

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$318.30$126.85RVU26D
2026-07-01$318.30$126.85RVU26C
2026-04-01$318.30$126.85RVU26B
2026-01-01$318.30$126.85RVU26A
2025-10-01$320.04$140.17RVU25D
2025-07-01$320.04$140.17RVU25C
2025-04-01$320.04$140.17RVU25B
2025-01-01$320.04$140.17RVU25A
2024-10-01$351.97$143.40RVU24D
2024-07-01$351.97$143.40RVU24C
2024-04-01$351.97$143.40RVU24B
2024-03-09$351.97$143.40RVU24AR
2024-01-01$346.23$141.06RVU24A
2023-10-01$364.13$145.87RVU23D
2023-07-01$364.13$145.87RVU23C
2023-04-01$364.13$145.87RVU23B
2023-01-01$364.13$145.87RVU23A
2022-10-01$378.14$147.43RVU22D
2022-07-01$378.14$147.43RVU22C
2022-04-01$378.14$147.43RVU22B
2022-01-01$378.14$147.43RVU22A
2021-10-01$365.41$149.20RVU21D
2021-07-01$365.41$149.20RVU21C
2021-04-01$365.41$149.20RVU21B
2021-01-01$365.41$149.20RVU21A
2020-10-01$329.64$153.57RVU20D
2020-07-01$329.64$153.57RVU20C
2020-04-01$329.64$153.57RVU20B
2020-01-01$329.64$153.57RVU20A
2019-10-01$300.84$152.69RVU19D
2019-07-01$300.84$152.69RVU19C
2019-04-01$300.84$152.69RVU19B
2019-01-01$300.84$152.69RVU19A
2018-10-01$271.43$153.41RVU18D
2018-07-01$271.43$153.41RVU18C
2018-04-01$271.43$153.41RVU18B
2018-01-01$271.43$153.41RVU18AR1
2017-10-01$270.27$154.28RVU17D
2017-07-01$270.27$154.28RVU17C
2017-04-01$270.27$154.28RVU17B
2017-01-01$270.27$154.28RVU17A
2016-10-01$311.25$187.95RVU16D
2016-07-01$311.25$187.95RVU16C
2016-04-01$311.25$187.95RVU16B
2016-01-01$311.25$187.95RVU16A
2015-10-01$304.45$189.72RVU15D
2015-07-01$304.45$189.72RVU15C
2015-04-01$302.93$188.78RVU15B
2015-01-01$302.93$188.78RVU15A
2014-10-01$302.78$191.07RVU14D
2014-07-01$302.78$191.07RVU14C
2014-04-01$302.78$191.07RVU14B
2014-01-01$302.78$191.07RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 58555 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

58555 billing questions

When should 58555 be chosen instead of 58558?

Use 58555 for diagnostic cavity inspection without sampling or tissue removal. When hysteroscopy includes endometrial sampling or biopsy, 58558 describes the operative service.

Can 58555 be reported with an operative hysteroscopy code?

The diagnostic inspection is generally integral to hysteroscopic biopsy or treatment and is not separately reported for the same procedure. Report the code describing the operative work performed.

What documentation supports 58555?

Document the clinical reason for evaluating the cavity, the hysteroscopic findings, and that no biopsy or therapeutic work was performed.

Should modifier 50 be appended?

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

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. CMS permits co-surgeons but does not permit team surgery for this code.

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 58555PPRRVU2026_Oct_nonQPP.csv, line 6,566 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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