Billing code 58565: Hysteroscopic sterilizationMedicare rate & RVUs
Reports permanent contraception performed by hysteroscopic placement of occlusive implants in both fallopian tubes through the uterine cavity.
Medicare pays $1,582.53 for 58565 nationally in the office and $404.15 in a hospital or facility. Local office rates run $1,378.06–$2,168.14.
Medicare rate · 58565
Hysteroscopic sterilization
Swap in your local Medicare rate.
- Work RVUs
- 6.94
- Total RVUs
- 47.38
- Global days
- 090
National rate · 2026
$1,582.53
Office setting, before claim adjustments.
See every locality for 58565 → · 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 58565 covers
A gynecologist passes a hysteroscope through the cervix to view the uterine cavity and place occlusive implants at both tubal openings, creating a transcervical method of permanent contraception. The procedure is typically performed in an operating or ambulatory surgery setting. It is distinct from tubal occlusion performed through abdominal incisions or laparoscopy because access is through the uterus and cervix.
Report 58565 when the documented service includes hysteroscopic implant placement for both tubes. The code is priced as bilateral, so modifier 50 does not increase payment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. CMS permits co-surgeons; team surgery is not permitted, and an assistant at surgery is not paid under the statutory restriction.
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 58565 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
$1378.06 to $2168.14
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,401.10 | $370.02 |
| Alaska* | $1,765.29 | $510.31 |
| Arizona | $1,536.06 | $394.20 |
| Arkansas | $1,378.06 | $365.83 |
| Atlanta | $1,612.38 | $415.14 |
| Austin | $1,654.33 | $407.60 |
| Bakersfield | $1,696.76 | $405.26 |
| Baltimore/Surr. Cntys | $1,691.53 | $427.12 |
| Beaumont | $1,461.74 | $389.41 |
| Brazoria | $1,563.63 | $395.86 |
| Chicago | $1,643.48 | $459.20 |
| Chico | $1,693.33 | $401.82 |
| Colorado | $1,660.23 | $406.43 |
| Connecticut | $1,696.60 | $427.48 |
| Dallas | $1,573.59 | $399.92 |
| Dc + Md/Va Suburbs | $1,832.83 | $444.70 |
| Delaware | $1,563.86 | $399.62 |
| Detroit | $1,564.64 | $427.50 |
| East St. Louis | $1,519.06 | $434.94 |
| El Centro | $1,693.53 | $402.02 |
| Fort Lauderdale | $1,632.49 | $438.79 |
| Fort Worth | $1,561.02 | $399.14 |
| Fresno | $1,693.33 | $401.82 |
| Galveston | $1,568.21 | $398.08 |
| Hanford-Corcoran | $1,693.33 | $401.82 |
| Hawaii, Guam | $1,744.85 | $405.02 |
| Houston | $1,590.54 | $420.41 |
| Idaho | $1,456.26 | $372.15 |
| Indiana | $1,465.96 | $373.60 |
| Iowa | $1,446.61 | $368.39 |
| Kansas | $1,436.56 | $371.31 |
| Kentucky | $1,433.66 | $386.08 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,818.07 | $424.05 |
| Madera | $1,693.33 | $401.82 |
| Manhattan | $1,833.47 | $464.18 |
| Merced | $1,693.33 | $401.82 |
| Metropolitan Boston | $1,841.69 | $434.70 |
| Metropolitan Kansas City | $1,501.69 | $395.19 |
| Metropolitan Philadelphia | $1,648.28 | $421.58 |
| Metropolitan St. Louis | $1,519.74 | $397.92 |
| Miami | $1,698.55 | $471.85 |
| Minnesota | $1,591.84 | $379.28 |
| Mississippi | $1,389.81 | $375.22 |
| Modesto | $1,693.33 | $401.82 |
| Montana** | $1,582.45 | $404.07 |
| Napa | $1,993.66 | $440.55 |
| Nebraska | $1,456.32 | $368.67 |
| Nevada** | $1,577.04 | $397.48 |
| New Hampshire | $1,631.15 | $404.45 |
| New Mexico | $1,482.00 | $401.42 |
| New Orleans | $1,510.79 | $401.93 |
| North Carolina | $1,480.06 | $380.62 |
| North Dakota** | $1,558.33 | $379.95 |
| Northern Nj | $1,809.51 | $442.58 |
| Nyc Suburbs/Long Island | $1,879.88 | $478.78 |
| Ohio | $1,468.89 | $393.03 |
| Oklahoma | $1,433.28 | $380.98 |
| Oxnard-Thousand Oaks-Ventura | $1,812.08 | $419.23 |
| Portland | $1,721.22 | $412.04 |
| Poughkpsie/N Nyc Suburbs | $1,725.97 | $435.64 |
| Puerto Rico | $1,596.33 | $404.99 |
| Queens | $1,853.80 | $460.95 |
| Redding | $1,693.33 | $401.82 |
| Rest Of California | $1,693.33 | $401.82 |
| Rest Of Florida | $1,545.39 | $418.86 |
| Rest Of Georgia | $1,448.88 | $397.76 |
| Rest Of Illinois | $1,491.51 | $415.64 |
| Rest Of Louisiana | $1,430.18 | $387.31 |
| Rest Of Maine | $1,462.33 | $378.22 |
| Rest Of Maryland | $1,597.23 | $404.71 |
| Rest Of Massachusetts | $1,647.40 | $406.56 |
| Rest Of Michigan | $1,473.82 | $397.96 |
| Rest Of Missouri | $1,400.70 | $384.93 |
| Rest Of New Jersey | $1,716.28 | $429.48 |
| Rest Of New York | $1,504.93 | $385.47 |
| Rest Of Oregon | $1,565.19 | $391.52 |
| Rest Of Pennsylvania | $1,472.87 | $391.12 |
| Rest Of Texas | $1,511.77 | $393.49 |
| Rest Of Washington | $1,645.24 | $404.40 |
| Rhode Island | $1,625.77 | $408.50 |
| Riverside-San Bernardino-Ontario | $1,706.48 | $414.97 |
| Sacramento-Roseville-Folsom | $1,785.50 | $415.04 |
| Salinas | $1,779.10 | $413.35 |
| San Diego-Chula Vista-Carlsbad | $1,827.58 | $418.24 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $2,119.60 | $458.08 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $2,118.22 | $456.70 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $2,168.14 | $468.91 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $2,162.47 | $463.24 |
| San Luis Obispo-Paso Robles | $1,749.66 | $407.48 |
| Santa Cruz-Watsonville | $1,850.14 | $418.41 |
| Santa Maria-Santa Barbara | $1,787.57 | $413.58 |
| Santa Rosa-Petaluma | $1,869.26 | $422.20 |
| Seattle (King Cnty) | $1,884.03 | $438.16 |
| South Carolina | $1,476.86 | $388.04 |
| South Dakota** | $1,555.48 | $377.09 |
| Southern Maine | $1,555.71 | $387.93 |
| Stockton | $1,693.33 | $401.82 |
| Suburban Chicago | $1,650.99 | $440.78 |
| Tennessee | $1,444.46 | $373.31 |
| Utah | $1,499.78 | $392.10 |
| Vallejo | $1,991.67 | $438.56 |
| Vermont | $1,549.30 | $382.70 |
| Virgin Islands | $1,596.33 | $404.99 |
| Virginia | $1,548.28 | $389.93 |
| Visalia | $1,693.33 | $401.82 |
| West Virginia | $1,428.49 | $404.47 |
| Wisconsin | $1,499.32 | $370.43 |
| Wyoming** | $1,571.94 | $393.56 |
| Yuba City | $1,693.33 | $401.82 |
58565 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$1,378.06
$1,930.74
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 | $1,765.29 | 1 |
| AL | $1,401.10 | 1 |
| AR | $1,378.06 | 1 |
| AZ | $1,536.06 | 1 |
| CA | $1,693.33–$2,168.14 | 29 |
| CO | $1,660.23 | 1 |
| CT | $1,696.60 | 1 |
| DC | $1,832.83 | 1 |
| DE | $1,563.86 | 1 |
| FL | $1,545.39–$1,698.55 | 3 |
| GA | $1,448.88–$1,612.38 | 2 |
| GU | $1,744.85 | 1 |
| HI | $1,744.85 | 1 |
| IA | $1,446.61 | 1 |
| ID | $1,456.26 | 1 |
| IL | $1,491.51–$1,650.99 | 4 |
| IN | $1,465.96 | 1 |
| KS | $1,436.56 | 1 |
| KY | $1,433.66 | 1 |
| LA | $1,430.18–$1,510.79 | 2 |
| MA | $1,647.40–$1,841.69 | 2 |
| MD | $1,597.23–$1,832.83 | 3 |
| ME | $1,462.33–$1,555.71 | 2 |
| MI | $1,473.82–$1,564.64 | 2 |
| MN | $1,591.84 | 1 |
| MO | $1,400.70–$1,519.74 | 3 |
| MS | $1,389.81 | 1 |
| MT | $1,582.45 | 1 |
| NC | $1,480.06 | 1 |
| ND | $1,558.33 | 1 |
| NE | $1,456.32 | 1 |
| NH | $1,631.15 | 1 |
| NJ | $1,716.28–$1,809.51 | 2 |
| NM | $1,482.00 | 1 |
| NV | $1,577.04 | 1 |
| NY | $1,504.93–$1,879.88 | 5 |
| OH | $1,468.89 | 1 |
| OK | $1,433.28 | 1 |
| OR | $1,565.19–$1,721.22 | 2 |
| PA | $1,472.87–$1,648.28 | 2 |
| PR | $1,596.33 | 1 |
| RI | $1,625.77 | 1 |
| SC | $1,476.86 | 1 |
| SD | $1,555.48 | 1 |
| TN | $1,444.46 | 1 |
| TX | $1,461.74–$1,654.33 | 8 |
| UT | $1,499.78 | 1 |
| VA | $1,548.28–$1,832.83 | 2 |
| VI | $1,596.33 | 1 |
| VT | $1,549.30 | 1 |
| WA | $1,645.24–$1,884.03 | 2 |
| WI | $1,499.32 | 1 |
| WV | $1,428.49 | 1 |
| WY | $1,571.94 | 1 |
How the 58565 rate is calculated
Each of 58565’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 · 58565
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.94Practice expense 39.22Malpractice 1.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 58565
58565 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58565
Hysteroscopic sterilization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 58565
Hysteroscopic sterilization
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58565 without 51 · national office
$1,582.53
Hysteroscopic sterilization
58565-51 · Second procedure: 50%
$791.27
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%).
58565 compared with similar codes
Compare codes
58565 vs 58671 vs 58670 vs 58600 vs 58555: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 58671Tubal occlusion
- This code describes laparoscopic occlusion of the tubes with a device. Choose 58565 for hysteroscopic placement through the cervix and uterine cavity.
- 58670Tubal sterilization
- This code uses laparoscopy to fulgurate the tubes, with or without transection. It is not the hysteroscopic implant procedure described by 58565.
- 58600Tubal division
- This code describes tubal ligation or transection through an abdominal or vaginal approach, rather than hysteroscopic implant placement.
- 58555Hysteroscopy
- This code is for diagnostic hysteroscopy. It does not describe placement of tubal implants for permanent contraception.
58565 billing questions
When should 58565 be chosen over laparoscopic sterilization?
Use 58565 for transcervical hysteroscopic placement of occlusive implants in both tubes. Laparoscopic tubal occlusion or fulguration is reported with a different code based on the method.
Should modifier 50 be appended?
The code is already priced as bilateral. Modifier 50 does not increase payment.
How does CMS price another endoscopy performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Separate reporting depends on the distinct service and applicable coding edits.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS permits co-surgeons for this code, but team surgery is not permitted. An assistant at surgery is not paid under the statutory restriction.
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
Fee sheets
Put 58565 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →