Billing code 58321: InseminationMedicare rate & RVUs
Reports placement of prepared sperm into the uterine cavity by catheter during fertility treatment, such as a planned intrauterine insemination cycle.
Medicare pays $83.84 for 58321 nationally in the office and $41.75 in a hospital or facility. Local office rates run $74.42–$106.07.
Medicare rate · 58321
Insemination
Swap in your local Medicare rate.
- Work RVUs
- 0.9
- Total RVUs
- 2.51
- Global days
- 000
National rate · 2026
$83.84
Office setting, before claim adjustments.
See every locality for 58321 → · 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
What 58321 covers
A clinician passes a thin catheter through the cervix and deposits sperm into the uterine cavity, commonly as part of a timed fertility treatment cycle. Gynecologists and reproductive endocrinologists typically perform the procedure in a fertility clinic or office. The sperm may come from a partner or donor; the insemination technique, rather than the sperm source, distinguishes this service from intracervical insemination.
Choose this code when sperm is placed in the uterus, and document the insemination site and procedure performed. Report sperm washing separately when that service is performed and documented. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. With multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 58321 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$74.42 to $106.07
109 of 109 payment localities
58321 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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.
$74.42
$99.62
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $99.62 | 1 |
| AL | $75.46 | 1 |
| AR | $74.42 | 1 |
| AZ | $81.57 | 1 |
| CA | $86.52–$106.07 | 29 |
| CO | $86.13 | 1 |
| CT | $89.29 | 1 |
| DC | $94.68 | 1 |
| DE | $82.87 | 1 |
| FL | $84.39–$93.99 | 3 |
| GA | $79.63–$85.78 | 2 |
| GU | $88.22 | 1 |
| HI | $88.22 | 1 |
| IA | $76.50 | 1 |
| ID | $77.15 | 1 |
| IL | $82.63–$91.21 | 4 |
| IN | $77.55 | 1 |
| KS | $76.54 | 1 |
| KY | $78.01 | 1 |
| LA | $78.04–$81.71 | 2 |
| MA | $85.80–$93.88 | 2 |
| MD | $84.28–$94.68 | 3 |
| ME | $77.94–$81.43 | 2 |
| MI | $80.31–$85.81 | 2 |
| MN | $81.48 | 1 |
| MO | $77.01–$81.52 | 3 |
| MS | $75.71 | 1 |
| MT | $83.83 | 1 |
| NC | $78.66 | 1 |
| ND | $80.66 | 1 |
| NE | $76.78 | 1 |
| NH | $85.15 | 1 |
| NJ | $90.01–$93.84 | 2 |
| NM | $80.89 | 1 |
| NV | $82.99 | 1 |
| NY | $79.83–$99.49 | 5 |
| OH | $79.67 | 1 |
| OK | $77.46 | 1 |
| OR | $82.06–$88.33 | 2 |
| PA | $79.57–$87.39 | 2 |
| PR | $84.29 | 1 |
| RI | $85.43 | 1 |
| SC | $79.35 | 1 |
| SD | $80.29 | 1 |
| TN | $76.95 | 1 |
| TX | $79.10–$86.10 | 8 |
| UT | $80.39 | 1 |
| VA | $81.44–$94.68 | 2 |
| VI | $84.29 | 1 |
| VT | $80.71 | 1 |
| WA | $85.52–$95.36 | 2 |
| WI | $78.10 | 1 |
| WV | $79.80 | 1 |
| WY | $82.45 | 1 |
How the 58321 rate is calculated
Each of 58321’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 · 58321
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.90Practice expense 1.45Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 58321
The CMS indicators that decide how 58321 is paid alongside other services.
CMS payment indicators · 58321
Insemination
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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) | 0 | Not 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
58321 without 51 · national office
$83.84
Insemination
58321-51 · Second procedure: 50%
$41.92
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%).
58321 compared with similar codes
Compare codes
58321 vs 58322 vs 58323 vs 58974: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 58322Artificial insemination
- The site of sperm placement determines the code: uterine cavity for 58321, cervix for 58322.
- 58323Sperm washing
- This code represents sperm washing, not catheter placement of sperm into the uterine cavity.
- 58974Embryo transfer intrauterine
- This code reports transfer of an embryo in an IVF cycle, not insemination with sperm.
58321 billing questions
How do I distinguish this from 58322?
Use 58321 when sperm is deposited in the uterine cavity. Code 58322 describes placement in the cervix.
Can sperm washing be reported separately?
Yes. When sperm washing is performed and documented, report 58323 separately from the insemination service.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. If multiple procedures are performed in the session, the highest-valued procedure is paid in full and others at 50%.
What documentation supports reporting 58321?
Document that sperm was placed in the uterine cavity, the procedure performed, and relevant details such as the sperm source and any separately performed sperm washing.
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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