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Billing code 58554: Vaginal hysterectomyMedicare rate & RVUs

Reports laparoscopic-assisted vaginal removal of a uterus weighing more than 250 grams, with removal of one or both fallopian tubes and/or ovaries.

CMS RVU26DEffective Oct 1, 2026109 payment localities105 Medicare services in 2024

Medicare pays $1,161.68 for 58554 nationally in a facility.

Medicare rate · 58554

Vaginal hysterectomy

Swap in your local Medicare rate.

Work RVUs
22.53
Total RVUs
34.78
Global days
090

National rate · 2026

$1,161.68

Facility setting, before claim adjustments.

See every locality for 58554 → · 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 58554 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 58554 covers

A gynecologic surgeon uses laparoscopy to assist with removal of the uterus through the vagina, along with removal of one or both fallopian tubes and/or ovaries. The code is for a uterus weighing more than 250 grams. This approach may be used for conditions such as a large fibroid uterus or other uterine disease when vaginal extraction is part of the operation; it is distinct from removing the uterus entirely through laparoscopic incisions.

Select the code based on the uterine weight and whether a tube or ovary was removed. The operative report should document the laparoscopic-assisted vaginal approach and adnexal removal; the specimen or pathology record can support the weight threshold. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment and co-surgeons, but not team surgery.

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 58554 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

58554 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,068.02
Alaska*Unavailable$1,493.81
ArizonaUnavailable$1,133.45
ArkansasUnavailable$1,056.65
AtlantaUnavailable$1,195.95
AustinUnavailable$1,163.25
BakersfieldUnavailable$1,148.24
Baltimore/Surr. CntysUnavailable$1,226.16
BeaumontUnavailable$1,127.47
BrazoriaUnavailable$1,134.98

58554 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
58554 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 58554 rate is calculated

Each of 58554’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 · 58554

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.53Practice expense 8.13Malpractice 4.12

34.7800 adjusted RVUs×$33.4009 conversion factor=$1,161.68

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

Payment rules and modifiers for 58554

58554 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58554

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)2Permitted.
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 · 58554

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

58554 without 51 · national facility

$1,161.68

Vaginal hysterectomy

58554-51 · Second procedure: 50%

$580.84

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

58554 compared with similar codes

Compare codes

58554 vs 58553 vs 58552 vs 58573 vs 58550: national Medicare rates

Swap in your local Medicare rate.

  • 58554
    Vaginal hysterectomy · 22.53 wRVU
    —
  • 58553
    Vaginal hysterectomy · 19.56 wRVU
    —
  • 58552
    Vaginal hysterectomy · 16.49 wRVU
    —
  • 58573
    Laparoscopic hysterectomy · 20.27 wRVU
    —
  • 58550
    Vaginal hysterectomy · 14.72 wRVU
    —

How to choose

58553Vaginal hysterectomy
Use 58553 for the same laparoscopic-assisted vaginal approach and uterus weight range when no tube or ovary is removed. This code includes removal of one or both.
58552Vaginal hysterectomy
Both include tube or ovary removal with a laparoscopic-assisted vaginal hysterectomy. Choose 58552 for a uterus weighing 250 grams or less; this code is for a uterus over 250 grams.
58573Laparoscopic hysterectomy
Both cover a uterus over 250 grams with tube or ovary removal. 58573 is for a total laparoscopic hysterectomy; this code uses laparoscopic assistance with vaginal hysterectomy.
58550Vaginal hysterectomy
58550 is for a uterus weighing 250 grams or less and does not include tube or ovary removal. This code covers the larger weight range and includes that removal.

Codes related to 58554

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

Codes related to 58554
CodeHow it relatesNational office range
Same family
58553Vaginal hysterectomySame approach and weight range, without the tube or ovary removal included here.No office rate
58552Vaginal hysterectomySame approach with tube or ovary removal, for a uterus weighing 250 grams or less.No office rate
58550Vaginal hysterectomySame approach for a uterus weighing 250 grams or less, without tube or ovary removal.No office rate
Used instead
58573Laparoscopic hysterectomyTotal laparoscopic approach for a uterus over 250 grams with tube or ovary removal.No office rate
58571Laparoscopic hysterectomyTotal laparoscopic approach with tube or ovary removal when the uterus weighs 250 grams or less.No office rate

58554 billing questions

How does this differ from 58553?

Both describe laparoscopic-assisted vaginal hysterectomy for a uterus over 250 grams. This code also covers removal of one or both tubes and/or ovaries; 58553 does not.

What documentation supports the weight threshold?

Document the operative approach and the uterus weight, with the specimen or pathology record supporting that it exceeds 250 grams. The record should also identify the tube or ovary removed.

Should modifier 50 be added for removal of both tubes or ovaries?

No. The descriptor includes removal of tube(s) and/or ovary(s), and the CMS bilateral adjustment does not apply.

How is this code affected when other procedures occur in the same session?

The standard multiple procedure reduction applies: the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

CMS permits assistant-at-surgery payment and co-surgeons for this procedure. Team surgery is not permitted.

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 58554PPRRVU2026_Oct_nonQPP.csv, line 6,565 (RVU26D)

Open CMS sourceHow we calculate rates

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