Billing code 58146: MyomectomyMedicare rate & RVUs

Medicare pays $1,014.72 for 58146 nationally in a facility.

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

What 58146 covers

A gynecologic surgeon removes uterine fibroids through an abdominal approach while preserving the uterus. This level is for cases meeting the high-burden threshold by fibroid count or total specimen weight: five or more intramural fibroids, or a total weight over 250 grams. The procedure is generally performed in a hospital or other surgical facility for patients seeking fibroid treatment without hysterectomy.

Select the level from the operative record, including the number of intramural fibroids removed and, when relevant, the total specimen weight. The record should establish the abdominal approach and the uterine-sparing procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require 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 58146 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

58146 rates by state

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

How the 58146 rate is calculated

Each of 58146’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.

Payment rules and modifiers for 58146

58146 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

58146 compared with similar codes

How to choose

58140Myomectomy

Both describe abdominal uterine-sparing fibroid removal. Choose 58146 when the intramural fibroid count or total weight meets the complex threshold; 58140 represents the lower level.

58145Myomectomy

This code is for the abdominal approach. Code 58145 is the vaginal-approach option, so the operative route distinguishes them.

58150Hysterectomy

Myomectomy removes fibroids while preserving the uterus. Code 58150 is for total abdominal hysterectomy, in which the uterus is removed.

58180Hysterectomy

This code preserves the uterus after fibroid removal. Code 58180 describes supracervical abdominal hysterectomy, which removes the uterus while retaining the cervix.

Codes related to 58146

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

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

Open CMS sourceHow we calculate rates