No office rate
Both are complicated vaginal hysterectomy services for a uterus over 250 grams. Choose 58291 when tube and/or ovary removal is part of the operation; choose 58290 without that removal.
On this page
CMS RVU26D · Effective 2026-10-01
58291 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1059.80
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Gynecologic surgery
About 58291: Complicated vaginal hysterectomy with adnexal removal
Reports a complicated vaginal hysterectomy for a uterus over 250 grams when one or both fallopian tubes or ovaries are also removed.
This code describes a complicated hysterectomy performed through the vagina for a uterus weighing more than 250 grams, with removal of one or both fallopian tubes and/or ovaries during the same operation. A gynecologic surgeon typically performs it in a hospital operating room. The operative report should establish the vaginal approach, the circumstances supporting the complicated service, the adnexal tissue removed, and uterine size or specimen weight.
Report this code rather than the corresponding vaginal hysterectomy code without adnexal removal when tube or ovary removal is part of the operation. The removal is included in this service; do not separately report it as though it were a distinct operation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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 available, and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate.
CMS billing rules for 58291
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.51 · 66%
- Practice expense (office) RVU7.43 · 23%
- Malpractice RVU3.77 · 12%
34
Medicare services in 2024 · #5589 by national volume
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.
58291 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
This code includes tube and/or ovary removal but applies to the smaller-uterus category. 58291 is for the complicated service involving a uterus over 250 grams.
No office rate
58292 is the related complicated vaginal hysterectomy service that includes enterocele repair. Use 58291 when adnexal removal is included and the additional repair is not the distinguishing service.
No office rate
58260 is the vaginal hysterectomy service without adnexal removal for the smaller-uterus category. 58291 includes adnexal removal and represents the complicated, over-250-gram service.
The same code, a different location
How does Wyoming** compare?
58291 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 58291
Office
Unavailable
Facility
$1006.87
No comparable office rate is available.
Arkansas
Arkansas · 58291
Office
Unavailable
Facility
$996.48
No comparable office rate is available.
Arizona
Arizona · 58291
Office
Unavailable
Facility
$1066.72
No comparable office rate is available.
Bakersfield
California · 58291
Office
Unavailable
Facility
$1080.78
No comparable office rate is available.
Chico
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
El Centro
California · 58291
Office
Unavailable
Facility
$1070.78
No comparable office rate is available.
Fresno
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Hanford-Corcoran
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Madera
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Merced
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Modesto
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Napa
California · 58291
Office
Unavailable
Facility
$1154.77
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 58291
Office
Unavailable
Facility
$1110.35
No comparable office rate is available.
Redding
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Rest Of California
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 58291
Office
Unavailable
Facility
$1110.79
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 58291
Office
Unavailable
Facility
$1100.43
No comparable office rate is available.
Salinas
California · 58291
Office
Unavailable
Facility
$1095.85
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 58291
Office
Unavailable
Facility
$1105.07
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 58291
Office
Unavailable
Facility
$1194.42
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 58291
Office
Unavailable
Facility
$1190.14
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 58291
Office
Unavailable
Facility
$1222.84
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 58291
Office
Unavailable
Facility
$1205.33
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 58291
Office
Unavailable
Facility
$1080.83
No comparable office rate is available.
Santa Cruz-Watsonville
California · 58291
Office
Unavailable
Facility
$1102.56
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 58291
Office
Unavailable
Facility
$1095.43
No comparable office rate is available.
Santa Rosa-Petaluma
California · 58291
Office
Unavailable
Facility
$1112.25
No comparable office rate is available.
Stockton
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Vallejo
California · 58291
Office
Unavailable
Facility
$1148.60
No comparable office rate is available.
Visalia
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Yuba City
California · 58291
Office
Unavailable
Facility
$1070.15
No comparable office rate is available.
Colorado
Colorado · 58291
Office
Unavailable
Facility
$1089.47
No comparable office rate is available.
Connecticut
Connecticut · 58291
Office
Unavailable
Facility
$1152.46
No comparable office rate is available.
Delaware
Delaware · 58291
Office
Unavailable
Facility
$1080.44
No comparable office rate is available.
Fort Lauderdale
Florida · 58291
Office
Unavailable
Facility
$1197.51
No comparable office rate is available.
Rest Of Florida
Florida · 58291
Office
Unavailable
Facility
$1144.96
No comparable office rate is available.
Atlanta
Georgia · 58291
Office
Unavailable
Facility
$1123.98
No comparable office rate is available.
Rest Of Georgia
Georgia · 58291
Office
Unavailable
Facility
$1089.92
No comparable office rate is available.
Hawaii, Guam
Hawaii · 58291
Office
Unavailable
Facility
$1073.53
No comparable office rate is available.
Iowa
Iowa · 58291
Office
Unavailable
Facility
$995.52
No comparable office rate is available.
Idaho
Idaho · 58291
Office
Unavailable
Facility
$1006.33
No comparable office rate is available.
East St. Louis
Illinois · 58291
Office
Unavailable
Facility
$1200.37
No comparable office rate is available.
Rest Of Illinois
Illinois · 58291
Office
Unavailable
Facility
$1141.85
No comparable office rate is available.
Suburban Chicago
Illinois · 58291
Office
Unavailable
Facility
$1201.48
No comparable office rate is available.
Indiana
Indiana · 58291
Office
Unavailable
Facility
$1009.70
No comparable office rate is available.
Kansas
Kansas · 58291
Office
Unavailable
Facility
$1006.26
No comparable office rate is available.
Kentucky
Kentucky · 58291
Office
Unavailable
Facility
$1054.29
No comparable office rate is available.
New Orleans
Louisiana · 58291
Office
Unavailable
Facility
$1095.03
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 58291
Office
Unavailable
Facility
$1058.72
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 58291
Office
Unavailable
Facility
$1156.29
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 58291
Office
Unavailable
Facility
$1091.63
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 58291
Office
Unavailable
Facility
$1152.00
No comparable office rate is available.
Rest Of Maryland
Maryland · 58291
Office
Unavailable
Facility
$1092.38
No comparable office rate is available.
Rest Of Maine
Maine · 58291
Office
Unavailable
Facility
$1025.09
No comparable office rate is available.
Southern Maine
Maine · 58291
Office
Unavailable
Facility
$1043.84
No comparable office rate is available.
Detroit
Michigan · 58291
Office
Unavailable
Facility
$1170.24
No comparable office rate is available.
Rest Of Michigan
Michigan · 58291
Office
Unavailable
Facility
$1087.20
No comparable office rate is available.
Minnesota
Minnesota · 58291
Office
Unavailable
Facility
$1011.09
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 58291
Office
Unavailable
Facility
$1074.51
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 58291
Office
Unavailable
Facility
$1080.88
No comparable office rate is available.
Rest Of Missouri
Missouri · 58291
Office
Unavailable
Facility
$1055.02
No comparable office rate is available.
Mississippi
Mississippi · 58291
Office
Unavailable
Facility
$1025.18
No comparable office rate is available.
Montana**
Montana · 58291
Office
Unavailable
Facility
$1092.29
No comparable office rate is available.
North Carolina
North Carolina · 58291
Office
Unavailable
Facility
$1030.46
No comparable office rate is available.
North Dakota**
North Dakota · 58291
Office
Unavailable
Facility
$1017.75
No comparable office rate is available.
Nebraska
Nebraska · 58291
Office
Unavailable
Facility
$995.11
No comparable office rate is available.
New Hampshire
New Hampshire · 58291
Office
Unavailable
Facility
$1086.98
No comparable office rate is available.
Northern Nj
New Jersey · 58291
Office
Unavailable
Facility
$1186.08
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 58291
Office
Unavailable
Facility
$1156.33
No comparable office rate is available.
New Mexico
New Mexico · 58291
Office
Unavailable
Facility
$1097.26
No comparable office rate is available.
Nevada**
Nevada · 58291
Office
Unavailable
Facility
$1071.76
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 58291
Office
Unavailable
Facility
$1293.34
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 58291
Office
Unavailable
Facility
$1174.89
No comparable office rate is available.
Queens
New York · 58291
Office
Unavailable
Facility
$1239.35
No comparable office rate is available.
Rest Of New York
New York · 58291
Office
Unavailable
Facility
$1042.74
No comparable office rate is available.
Ohio
Ohio · 58291
Office
Unavailable
Facility
$1071.96
No comparable office rate is available.
Oklahoma
Oklahoma · 58291
Office
Unavailable
Facility
$1037.91
No comparable office rate is available.
Portland
Oregon · 58291
Office
Unavailable
Facility
$1099.35
No comparable office rate is available.
Rest Of Oregon
Oregon · 58291
Office
Unavailable
Facility
$1054.15
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 58291
Office
Unavailable
Facility
$1139.95
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 58291
Office
Unavailable
Facility
$1065.27
No comparable office rate is available.
Puerto Rico
Puerto Rico · 58291
Office
Unavailable
Facility
$1093.38
No comparable office rate is available.
Rhode Island
Rhode Island · 58291
Office
Unavailable
Facility
$1100.78
No comparable office rate is available.
South Carolina
South Carolina · 58291
Office
Unavailable
Facility
$1054.79
No comparable office rate is available.
South Dakota**
South Dakota · 58291
Office
Unavailable
Facility
$1008.93
No comparable office rate is available.
Tennessee
Tennessee · 58291
Office
Unavailable
Facility
$1011.66
No comparable office rate is available.
Austin
Texas · 58291
Office
Unavailable
Facility
$1094.02
No comparable office rate is available.
Beaumont
Texas · 58291
Office
Unavailable
Facility
$1061.27
No comparable office rate is available.
Brazoria
Texas · 58291
Office
Unavailable
Facility
$1068.35
No comparable office rate is available.
Dallas
Texas · 58291
Office
Unavailable
Facility
$1080.14
No comparable office rate is available.
Fort Worth
Texas · 58291
Office
Unavailable
Facility
$1079.29
No comparable office rate is available.
Galveston
Texas · 58291
Office
Unavailable
Facility
$1074.90
No comparable office rate is available.
Houston
Texas · 58291
Office
Unavailable
Facility
$1143.90
No comparable office rate is available.
Rest Of Texas
Texas · 58291
Office
Unavailable
Facility
$1067.67
No comparable office rate is available.
Utah
Utah · 58291
Office
Unavailable
Facility
$1064.81
No comparable office rate is available.
Virginia
Virginia · 58291
Office
Unavailable
Facility
$1051.30
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 58291
Office
Unavailable
Facility
$1093.38
No comparable office rate is available.
Vermont
Vermont · 58291
Office
Unavailable
Facility
$1027.86
No comparable office rate is available.
Rest Of Washington
Washington · 58291
Office
Unavailable
Facility
$1084.94
No comparable office rate is available.
Seattle (King Cnty)
Washington · 58291
Office
Unavailable
Facility
$1161.76
No comparable office rate is available.
Wisconsin
Wisconsin · 58291
Office
Unavailable
Facility
$994.98
No comparable office rate is available.
West Virginia
West Virginia · 58291
Office
Unavailable
Facility
$1114.31
No comparable office rate is available.
See how rates vary across the country
58291 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 58291 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1165.78
$1059.80 × 110% = $1165.78
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 58291 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
6,537
- Code
- 58291
- Physician work
- 21.51
- Practice expense
- 7.43
- Malpractice
- 3.77
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.51 | × 1.000 | 21.5100 |
| Practice expense | 7.43 | × 1.000 | 7.4300 |
| Malpractice | 3.77 | × 0.740 | 2.7898 |
| Total RVUs | 31.7298 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1059.80
Open 58291 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.51 | 1 |
| Practice expense | 7.43 | 1 |
| Malpractice | 3.77 | 0.74 |
(21.51 × 1 + 7.43 × 1 + 3.77 × 0.74) × $33.4009 = $1059.80
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
58291 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1059.80 | RVU26D |
| 2026-07-01 | Not available in this setting | $1059.80 | RVU26C |
| 2026-04-01 | Not available in this setting | $1059.80 | RVU26B |
| 2026-01-01 | Not available in this setting | $1059.80 | RVU26A |
| 2025-10-01 | Not available in this setting | $1176.67 | RVU25D |
| 2025-07-01 | Not available in this setting | $1176.67 | RVU25C |
| 2025-04-01 | Not available in this setting | $1176.67 | RVU25B |
| 2025-01-01 | Not available in this setting | $1176.67 | RVU25A |
58291 billing questions
How does this differ from 58290?
Both describe a complicated vaginal hysterectomy for a uterus over 250 grams. Use 58291 when one or both tubes and/or ovaries are also removed; 58290 is the counterpart without that removal.
Can tube or ovary removal be billed separately?
Removal of one or both fallopian tubes and/or ovaries is included in 58291 when performed as part of the hysterectomy. The code already accounts for that work.
What documentation supports the complicated service?
The operative report should describe the vaginal approach, why the operation was complicated, which adnexal structures were removed, and the uterine size or specimen weight supporting the over-250-gram category.
What 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 modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeons for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,53458280,,Hysterectomy/revise vagina,A,,17.87,6.92,NA,6.92,,3.13,27.92,27.92,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53558285,,Extensive hysterectomy,A,,22.80,11.71,NA,11.71,,5.27,39.78,39.78,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53658290,,Vag hyst complex,A,,19.76,7.06,NA,7.06,,3.46,30.28,30.28,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53758291,,Vag hyst incl t/o complex,A,,21.51,7.43,NA,7.43,,3.77,32.71,32.71,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53858292,,Vag hyst t/o & repair compl,A,,22.77,7.69,NA,7.69,,3.99,34.45,34.45,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53958294,,Vag hyst w/enterocele compl,A,,21.01,7.33,NA,7.33,,3.68,32.02,32.02,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,54058300,,Insert intrauterine device,N,+,0.98,2.07,,0.22,,0.11,3.16,1.31,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,