No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
58554 Vaginal hysterectomy Medicare reimbursement rates in California
Reports laparoscopic-assisted vaginal removal of a uterus weighing more than 250 grams, with removal of one or both fallopian tubes and/or ovaries. Compare 58554 office and facility rates across CMS payment localities in California.
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 58554 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1136.69–$1300.63
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $163.94 per service.
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.
Where 58554 pays more and less in California
Gynecology surgery
About 58554: Complex laparoscopic-assisted vaginal hysterectomy with adnexal removal
Reports laparoscopic-assisted vaginal removal of a uterus weighing more than 250 grams, with removal of one or both fallopian tubes and/or ovaries.
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.
CMS billing rules for 58554
- 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 RVU22.53 · 65%
- Practice expense (office) RVU8.13 · 23%
- Malpractice RVU4.12 · 12%
105
Medicare services in 2024 · #4845 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.
58554 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
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.
No office rate
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.
No office rate
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.
Compare 58554 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1148.24 |
| Chico | Office Unavailable | Facility $1136.69 |
| El Centro | Office Unavailable | Facility $1137.38 |
| Fresno | Office Unavailable | Facility $1136.69 |
| Hanford-Corcoran | Office Unavailable | Facility $1136.69 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1195.99 |
| Madera | Office Unavailable | Facility $1136.69 |
| Merced | Office Unavailable | Facility $1136.69 |
| Modesto | Office Unavailable | Facility $1136.69 |
| Napa | Office Unavailable | Facility $1227.74 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1180.30 |
| Redding | Office Unavailable | Facility $1136.69 |
| Rest Of California | Office Unavailable | Facility $1136.69 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1181.07 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1169.18 |
| Salinas | Office Unavailable | Facility $1164.34 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1174.46 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1270.06 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1265.38 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1300.63 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1281.51 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1148.37 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1172.02 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1163.98 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1182.32 |
| Stockton | Office Unavailable | Facility $1136.69 |
| Vallejo | Office Unavailable | Facility $1221.00 |
| Visalia | Office Unavailable | Facility $1136.69 |
| Yuba City | Office Unavailable | Facility $1136.69 |
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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 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.
6,56258550,,Laparo-asst vag hysterectomy,A,,14.72,6.21,NA,6.21,,2.62,23.55,23.55,0,090,0.12,0.74,0.14,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
6,56358552,,Laparo-vag hyst incl t/o,A,,16.49,6.76,NA,6.76,,3.02,26.27,26.27,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56458553,,Laparo-vag hyst complex,A,,19.56,6.52,NA,6.52,,3.43,29.51,29.51,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56558554,,Laparo-vag hyst w/t/o compl,A,,22.53,8.13,NA,8.13,,4.12,34.78,34.78,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56658555,,Hysteroscopy dx sep proc,A,,2.58,6.79,,1.00,,0.45,9.82,4.03,0,000,0.00,0.00,0.00,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56758558,,Hysteroscopy biopsy,A,,4.07,33.23,,1.33,,0.72,38.02,6.12,0,000,0.00,0.00,0.00,3,0,1,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
6,56858559,,Hysteroscopy lysis,A,,5.07,1.50,NA,1.50,,0.89,7.46,7.46,0,000,0.00,0.00,0.00,3,0,1,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00