CPT code 58563: Hysteroscopy, endometrial ablation2026 Medicare rate & RVUs in California
Hysteroscopic endometrial ablation destroys the uterine lining and is reported for an operative procedure to treat selected cases of abnormal uterine bleeding.
Medicare pays $2,175.84–$2,825.12 for 58563 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
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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On this page 9 sections
What 58563 covers
A gynecologic surgeon passes a hysteroscope through the cervix to inspect the uterine cavity and ablate the endometrium using an appropriate operative method. The procedure is commonly performed in a hospital or ambulatory surgery setting for patients with abnormal uterine bleeding after clinical evaluation. It treats the uterine lining; it is distinct from removing a fibroid or ablating a uterine fibroid.
Report the procedure when the operative record supports endometrial ablation, rather than diagnostic inspection or treatment of a separate intrauterine target. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. CMS permits co-surgeons; assistant-at-surgery payment requires documented medical necessity, 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 58563 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$2175.84 to $2825.12
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $2,178.03 | $214.05 |
| Chico, CA | $2,175.84 | $211.85 |
| El Centro, CA | $2,175.97 | $211.98 |
| Fresno, CA | $2,175.84 | $211.85 |
| Hanford, CA | $2,175.84 | $211.85 |
| Los Angeles, CA | $2,342.52 | $222.64 |
| Madera, CA | $2,175.84 | $211.85 |
| Marin County, CA | $2,762.13 | $235.47 |
| Merced, CA | $2,175.84 | $211.85 |
| Modesto, CA | $2,175.84 | $211.85 |
| Napa, CA | $2,589.71 | $227.91 |
| Oxnard, CA | $2,337.72 | $219.63 |
| Redding, CA | $2,175.84 | $211.85 |
| Rest of California | $2,175.84 | $211.85 |
| Riverside, CA | $2,184.24 | $220.26 |
| Sacramento, CA | $2,301.71 | $217.66 |
| Salinas, CA | $2,293.63 | $216.75 |
| San Benito County, CA | $2,825.12 | $241.11 |
| San Diego, CA | $2,361.63 | $218.45 |
| San Francisco, CA | $2,761.25 | $234.58 |
| San Luis Obispo, CA | $2,254.85 | $213.81 |
| Santa Clara County, CA | $2,821.50 | $237.49 |
| Santa Cruz, CA | $2,395.07 | $217.84 |
| Santa Maria, CA | $2,306.06 | $216.64 |
| Santa Rosa, CA | $2,420.27 | $219.74 |
| Stockton, CA | $2,175.84 | $211.85 |
| Vallejo, CA | $2,588.43 | $226.63 |
| Visalia, CA | $2,175.84 | $211.85 |
| Yuba City, CA | $2,175.84 | $211.85 |
How the 58563 rate is calculated
Each of 58563’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 · 58563
RVUs × geographic indexes × conversion factor
Work4.36
4.36 RVUs× 1.000 GPCI
Practice expense55.01
55.01 RVUs× 1.000 GPCI
Malpractice0.78
0.78 RVUs× 1.000 GPCI
Adjusted RVUs
60.1500
Conversion factor
$33.4009
Medicare rate
$2,009.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58563
The CMS indicators that decide how 58563 is paid alongside other services.
CMS payment indicators · 58563
Hysteroscopy, endometrial ablation
| 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) | 0 | Not paid without supporting documentation. |
| 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
58563 without 51 · national office
$2,009.06
Hysteroscopy, endometrial ablation
58563-51 · Second procedure: 50%
$1,004.53
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%).
58563 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 58558HysteroscopyBiopsy or polyp removal
- Choose 58558 for hysteroscopic endometrial sampling or tissue removal. Choose 58563 when the operative service ablates the endometrial lining.
- 58561Myoma removalHysteroscopic approach
- 58561 is for hysteroscopic removal of a uterine fibroid. This code treats the endometrium, not a fibroid.
- 58555HysteroscopyDiagnostic only
- 58555 describes diagnostic hysteroscopy. This code requires an operative endometrial ablation, not inspection alone.
- 58580Fibroid ablationTranscervical radiofrequency
- 58580 is a transcervical radiofrequency procedure directed at uterine fibroids. This code is for hysteroscopic ablation of the endometrium.
58563 billing questions
How does this differ from hysteroscopy with biopsy?
This code represents operative ablation of the endometrium. Use 58558 when the documented service is hysteroscopic tissue sampling or removal of endometrial tissue, rather than ablation.
Can diagnostic hysteroscopy be reported separately?
When the surgeon performs diagnostic inspection as part of the operative ablation, it is integral to that service. The record should identify the ablation performed, not just visualization.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inapplicable for this code; modifier 50 is inappropriate.
What is the global-period treatment?
The code has a 0-day global period. Same-day preoperative and postoperative care is included.
When can an assistant-at-surgery be paid?
Only when documentation supports medical necessity. CMS permits co-surgeons, but not 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
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