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Billing code 58960: Cancer stagingMedicare rate & RVUs

Reports abdominal exploration by laparotomy to stage or restage ovarian, tubal, or primary peritoneal malignancy, with or without associated sampling.

CMS RVU26DEffective Oct 1, 2026109 payment localities37 Medicare services in 2024

Medicare pays $943.58 for 58960 nationally in a facility.

Medicare rate · 58960

Cancer staging

Swap in your local Medicare rate.

Work RVUs
15.4
Total RVUs
28.25
Global days
090

National rate · 2026

$943.58

Facility setting, before claim adjustments.

See every locality for 58960 → · 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 58960 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 58960 covers

A gynecologic oncologist typically performs this open abdominal exploration to assess the extent of ovarian, fallopian tube, or primary peritoneal malignancy for staging or restaging. The operation may include inspection and sampling of the peritoneum, diaphragm, pelvis, or abdominal lymph nodes, peritoneal washings, and omentectomy. It is used for a planned staging or second-look operation, rather than as a general code for any abdominal exploration or for ovarian tumor removal alone.

The operative report should establish the malignancy and the staging or restaging purpose, and describe the exploration and any associated procedures. Biopsies, washings, or omentectomy performed as part of this staging service are within its scope. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 58960 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

58960 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$853.08
Alaska*Unavailable$1,167.37
ArizonaUnavailable$916.80
ArkansasUnavailable$842.04
AtlantaUnavailable$974.05
AustinUnavailable$948.99
BakersfieldUnavailable$936.48
Baltimore/Surr. CntysUnavailable$1,002.69
BeaumontUnavailable$907.21
BrazoriaUnavailable$918.67

58960 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
58960 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 58960 rate is calculated

Each of 58960’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 · 58960

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.40Practice expense 9.28Malpractice 3.57

28.2500 adjusted RVUs×$33.4009 conversion factor=$943.58

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

Payment rules and modifiers for 58960

58960 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58960

Cancer staging

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 · 58960

Cancer staging

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

58960 without 51 · national facility

$943.58

Cancer staging

58960-51 · Second procedure: 50%

$471.79

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

58960 compared with similar codes

Compare codes

58960 vs 49000 vs 58900 vs 58950 vs 58951: national Medicare rates

Swap in your local Medicare rate.

  • 58960
    Cancer staging · 15.4 wRVU
    —
  • 49000
    Abdominal exploration · 12.23 wRVU
    —
  • 58900
    Ovarian biopsy · 6.43 wRVU
    —
  • 58950
    Cancer resection · 17.91 wRVU
    —
  • 58951
    Ovarian cancer surgery · 23.65 wRVU
    —

How to choose

49000Abdominal exploration
49000 describes general exploratory laparotomy. Choose 58960 when the open exploration is specifically for staging or restaging ovarian, tubal, or primary peritoneal malignancy.
58900Ovarian biopsy
58900 is for ovarian biopsy. It does not represent the broader laparotomy performed to stage or restage gynecologic malignancy.
58950Cancer resection
58950 is a resection service for ovarian malignancy. Choose 58960 when the operation is for staging or restaging rather than the resection described by 58950.
58951Ovarian cancer surgery
58951 describes ovarian malignancy resection with debulking elements. 58960 is the staging or restaging exploration service.

Codes related to 58960

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

Codes related to 58960
CodeHow it relatesNational office range
Used instead
49000Abdominal explorationGeneral exploratory laparotomy; 58960 is for malignancy staging or restaging.No office rate
58900Ovarian biopsyOvarian biopsy alone, rather than a comprehensive staging or restaging laparotomy.No office rate
58950Cancer resectionOvarian malignancy resection service for a different operative purpose.No office rate
58951Ovarian cancer surgeryResection and debulking service, rather than staging exploration.No office rate
58952Cancer debulkingOvarian malignancy debulking code; distinguish by the resection performed.No office rate
58953Cancer debulkingRadical debulking service, not a staging or second-look exploration.No office rate

58960 billing questions

When should 58960 be chosen instead of an ovarian malignancy resection code?

Use 58960 for a laparotomy whose purpose is staging or restaging ovarian, tubal, or primary peritoneal malignancy. Use a resection code when the operation is the specified tumor-resection or debulking service.

Are biopsies and washings separately reported with 58960?

Biopsies and peritoneal washings performed as part of the staging exploration are included in the service. Omentectomy may also be part of the reported staging operation.

Can modifier 50 be used for 58960?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the multiple-procedure reduction affect 58960?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

What assistant or co-surgeon rules apply?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What postoperative care is included?

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

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 58960PPRRVU2026_Oct_nonQPP.csv, line 6,619 (RVU26D)

Open CMS sourceHow we calculate rates

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