No office rate
Both describe abdominal uterine-sparing fibroid removal. Choose 58146 when the intramural fibroid count or total weight meets the complex threshold; 58140 represents the lower level.
On this page
CMS RVU26D · Effective 2026-10-01
58146 Myomectomy Medicare reimbursement rates in Alabama
Reports abdominal removal of a substantial fibroid burden when the surgeon preserves the uterus and the documented count or weight meets the complex level. Compare 58146 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 58146 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$934.86
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gynecologic surgery
About 58146: Complex abdominal uterine fibroid removal
Reports abdominal removal of a substantial fibroid burden when the surgeon preserves the uterus and the documented count or weight meets the complex level.
A gynecologic surgeon removes uterine fibroids through an abdominal approach while preserving the uterus. This level is for cases meeting the high-burden threshold by fibroid count or total specimen weight: five or more intramural fibroids, or a total weight over 250 grams. The procedure is generally performed in a hospital or other surgical facility for patients seeking fibroid treatment without hysterectomy.
Select the level from the operative record, including the number of intramural fibroids removed and, when relevant, the total specimen weight. The record should establish the abdominal approach and the uterine-sparing procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 58146
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.83 · 65%
- Practice expense (office) RVU7.08 · 23%
- Malpractice RVU3.47 · 11%
40
Medicare services in 2024 · #5504 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.
58146 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
This code is for the abdominal approach. Code 58145 is the vaginal-approach option, so the operative route distinguishes them.
No office rate
Myomectomy removes fibroids while preserving the uterus. Code 58150 is for total abdominal hysterectomy, in which the uterus is removed.
No office rate
This code preserves the uterus after fibroid removal. Code 58180 describes supracervical abdominal hysterectomy, which removes the uterus while retaining the cervix.
Compare 58146 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$934.86
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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 58146 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,521
- Code
- 58146
- Physician work
- 19.83
- Practice expense
- 7.08
- Malpractice
- 3.47
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.83 | × 1.000 | 19.8300 |
| Practice expense | 7.08 | × 0.875 | 6.1950 |
| Malpractice | 3.47 | × 0.566 | 1.9640 |
| Total RVUs | 27.9890 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$934.86
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.83 | 1 |
| Practice expense | 7.08 | 0.875 |
| Malpractice | 3.47 | 0.566 |
(19.83 × 1 + 7.08 × 0.875 + 3.47 × 0.566) × $33.4009 = $934.86
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.
58146 billing questions
How is this level distinguished from 58140?
Use this complex level when the case meets the threshold by count or weight: five or more intramural fibroids, or total specimen weight over 250 grams. Code 58140 is the lower abdominal myomectomy level.
Does the fibroid count or total weight determine the level?
Either qualifying measure supports the complex level. Document the intramural fibroid count and specimen weight when available so the operative record supports the selected code.
Is modifier 50 appropriate for fibroids on both sides of the uterus?
No. CMS identifies bilateral adjustment as inappropriate for this code; the descriptor and anatomy do not support modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
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.
6,51858120,,Dilation and curettage,A,,3.50,4.78,,2.13,,0.65,8.93,6.28,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,51958140,,Myomectomy abdom method,A,,15.40,6.24,NA,6.24,,2.70,24.34,24.34,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52058145,,Myomectomy vag method,A,,8.69,4.74,NA,4.74,,1.51,14.94,14.94,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52158146,,Myomectomy abdom complex,A,,19.83,7.08,NA,7.08,,3.47,30.38,30.38,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52258150,,Total hysterectomy,A,,16.88,7.65,NA,7.65,,3.41,27.94,27.94,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52358152,,Total hysterectomy,A,,21.31,7.59,NA,7.59,,3.74,32.64,32.64,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52458180,,Partial hysterectomy,A,,16.19,6.73,NA,6.73,,3.03,25.95,25.95,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515