CPT code 58559: Hysteroscopy, intrauterine adhesion lysis2026 Medicare rate & RVUs in Missouri
Report this operative hysteroscopy when the surgeon uses an instrument to divide adhesions inside the uterine cavity, such as those causing cavity distortion.
CMS doesn’t publish an office rate for 58559 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 58559 covers
A gynecologist or other qualified surgeon uses a hysteroscope passed through the cervix to visualize and divide scar bands within the uterine cavity. This treatment may be performed for intrauterine adhesions that distort the cavity, including adhesions associated with Asherman syndrome. The procedure is commonly done in a hospital or ambulatory surgery center; it may also be performed in an appropriately equipped office setting.
Select this code when the operative work is lysis of intrauterine adhesions, not simply diagnostic inspection or treatment of a septum, myoma, polyp, or retained foreign body. The operative report should identify the adhesions and document the hysteroscopic treatment performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is not.
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 58559 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 | $245.43 |
| Metropolitan St. Louis, MO | Unavailable | $246.83 |
| Rest of Missouri | Unavailable | $241.48 |
How the 58559 rate is calculated
Each of 58559’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 · 58559
RVUs × geographic indexes × conversion factor
Work5.07
5.07 RVUs× 1.000 GPCI
Practice expense1.50
1.50 RVUs× 1.000 GPCI
Malpractice0.89
0.89 RVUs× 1.000 GPCI
Adjusted RVUs
7.4600
Conversion factor
$33.4009
Medicare rate
$249.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58559
The CMS indicators that decide how 58559 is paid alongside other services.
CMS payment indicators · 58559
Hysteroscopy, intrauterine adhesion lysis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58559 without 51 · national facility
$249.17
Hysteroscopy, intrauterine adhesion lysis
58559-51 · Second procedure: 50%
$124.59
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%).
58559 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 58555HysteroscopyDiagnostic only
- Use 58555 for diagnostic cavity inspection without operative treatment. Adhesion division is reported with 58559, and the same-session inspection is not separately reported.
- 58558HysteroscopyBiopsy or polyp removal
- Use 58558 when the hysteroscopic work is biopsy or polypectomy. Use 58559 when the operative target is intrauterine adhesions.
- 58560HysteroscopyUterine septum resection
- Use 58560 for hysteroscopic treatment of a uterine septum; 58559 addresses adhesions within the cavity.
- 58561Myoma removalHysteroscopic approach
- Use 58561 when hysteroscopy removes a uterine myoma. Adhesion lysis, rather than myoma removal, supports 58559.
58559 billing questions
How is this different from diagnostic hysteroscopy?
This code is for operative division of adhesions inside the uterine cavity. Diagnostic hysteroscopy alone is reported with 58555; same-session diagnostic inspection is generally part of the operative hysteroscopy.
Can diagnostic hysteroscopy be billed separately on the same date?
Do not separately report 58555 for the inspection that guides the same-session adhesion treatment. The operative service includes visualization of the cavity.
Is the code reported per adhesion?
The code represents the hysteroscopic lysis service, not a unit for each adhesion or scar band. Document the findings and the treatment performed.
Should modifier 50 be used for adhesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What are the assistant and co-surgeon rules?
CMS does not pay an assistant at surgery for this service. Co-surgeons are permitted, but team surgery is not.
What global-period care is included?
The code has a 0-day global period. Same-day preoperative and postoperative care is included.
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
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