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Billing code 58290: Vaginal hysterectomyMedicare rate & RVUs

Reports removal of an enlarged uterus through the vaginal route when its weight exceeds 250 grams and no additional coded procedure changes the service.

CMS RVU26DEffective Oct 1, 2026109 payment localities28 Medicare services in 2024

Medicare pays $1,011.38 for 58290 nationally in a facility.

Medicare rate · 58290

Vaginal hysterectomy

Swap in your local Medicare rate.

Work RVUs
19.76
Total RVUs
30.28
Global days
090

National rate · 2026

$1,011.38

Facility setting, before claim adjustments.

See every locality for 58290 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 58290 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 58290 covers

This code represents removal of the uterus through the vagina when the uterus weighs more than 250 grams. Gynecologic surgeons commonly perform the operation in a hospital or other surgical facility for conditions such as symptomatic fibroids or uterine prolapse when a vaginal approach is selected. The operative report should establish the route and document the uterine weight or other support for the applicable weight category.

Choose this code based on the vaginal approach and uterine weight, then check whether removal of tubes or ovaries or repair of an enterocele calls for a different sibling code. This is major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 58290 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

58290 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$931.75
Alaska*Unavailable$1,304.82
ArizonaUnavailable$987.43
ArkansasUnavailable$922.08
AtlantaUnavailable$1,040.36
AustinUnavailable$1,013.20
BakersfieldUnavailable$1,001.37
Baltimore/Surr. CntysUnavailable$1,066.54
BeaumontUnavailable$981.95
BrazoriaUnavailable$989.11

58290 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
58290 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 58290 rate is calculated

Each of 58290’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 · 58290

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.76Practice expense 7.06Malpractice 3.46

30.2800 adjusted RVUs×$33.4009 conversion factor=$1,011.38

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 58290

58290 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58290

Vaginal hysterectomy

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 · 58290

Vaginal hysterectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

58290 without 51 · national facility

$1,011.38

Vaginal hysterectomy

58290-51 · Second procedure: 50%

$505.69

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

58290 compared with similar codes

Compare codes

58290 vs 58260 vs 58291 vs 58294: national Medicare rates

Swap in your local Medicare rate.

  • 58290
    Vaginal hysterectomy · 19.76 wRVU
    —
  • 58260
    Vaginal hysterectomy · 13.8 wRVU
    —
  • 58291
    Vaginal hysterectomy · 21.51 wRVU
    —
  • 58294
    Vaginal hysterectomy · 21.01 wRVU
    —

How to choose

58260Vaginal hysterectomy
Both use the vaginal route, but 58260 applies when the uterus weighs 250 grams or less; 58290 is for a uterus over 250 grams.
58291Vaginal hysterectomy
Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58291 when tube(s) and/or ovary(s) are also removed.
58294Vaginal hysterectomy
Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58294 when the operation also includes repair of an enterocele.

Codes related to 58290

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

Codes related to 58290
CodeHow it relatesNational office range
Same family
58260Vaginal hysterectomyVaginal hysterectomy for a uterus weighing 250 grams or less.No office rate
58291Vaginal hysterectomyVaginal hysterectomy for a larger uterus with removal of tube(s) and/or ovary(s).No office rate
58292Vaginal hysterectomyLarger-uterus vaginal hysterectomy with adnexal removal and enterocele repair.No office rate
58294Vaginal hysterectomyLarger-uterus vaginal hysterectomy with enterocele repair.No office rate
58262Vaginal hysterectomyVaginal hysterectomy for a smaller uterus with removal of tube(s) and/or ovary(s).No office rate

58290 billing questions

How is this code distinguished from 58260?

Both describe vaginal hysterectomy, but 58290 is for a uterus weighing more than 250 grams. Code 58260 is for a uterus weighing 250 grams or less.

When should a neighboring code replace 58290?

Use the applicable sibling when the operation also includes removal of tubes or ovaries or repair of an enterocele. The operative report should support the additional work and code selection.

Is modifier 50 appropriate?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included?

The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

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

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 58290PPRRVU2026_Oct_nonQPP.csv, line 6,536 (RVU26D)

Open CMS sourceHow we calculate rates

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