No office rate
Both include vaginal hysterectomy for a uterus of 250 g or less and adnexal removal. Choose 58263 when an enterocele is also repaired.
On this page
CMS RVU26D · Effective 2026-10-01
58263 Vaginal hysterectomy Medicare reimbursement rates in Delaware
Reports vaginal removal of a uterus weighing 250 g or less with removal of one or both adnexa and repair of an enterocele. Compare 58263 office and facility rates across CMS payment localities in Delaware.
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 58263 in Delaware?
Delaware 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
$867.77
1 of 1 localities have a supported rate.
Payment area: Delaware
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 58263: Vaginal hysterectomy with adnexal and enterocele repair
Reports vaginal removal of a uterus weighing 250 g or less with removal of one or both adnexa and repair of an enterocele.
This service covers removal of the uterus through the vagina when it weighs 250 g or less, removal of one or both fallopian tubes and/or ovaries, and repair of an enterocele. Gynecologic surgeons commonly perform it for patients undergoing vaginal surgery for uterine and pelvic support conditions. The operative report should establish the vaginal route and document the adnexal removal and enterocele repair; the specimen weight supports selection of the 250-g-or-less family.
Report this combination code when all of its included work is performed. Do not separately report the adnexal removal or enterocele repair as though they were separate services. Medicare’s 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery and co-surgeon payment may be allowed; team surgery is not permitted.
CMS billing rules for 58263
- 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 RVU16.80 · 64%
- Practice expense (office) RVU6.55 · 25%
- Malpractice RVU2.92 · 11%
270
Medicare services in 2024 · #4076 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.
58263 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
This code includes an enterocele repair but not adnexal removal. Use 58263 when tube(s) and/or ovary(s) are also removed.
No office rate
This variant includes urinary repair rather than the enterocele repair included in 58263.
No office rate
This is the related more complex, larger-uterus variant with adnexal removal and repair; 58263 is for a uterus weighing 250 g or less.
Compare 58263 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
Delaware →
Office / nonfacility
Unavailable
Facility
$867.77
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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 58263 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,530
- Code
- 58263
- Physician work
- 16.80
- Practice expense
- 6.55
- Malpractice
- 2.92
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.80 | × 1.005 | 16.8840 |
| Practice expense | 6.55 | × 0.988 | 6.4714 |
| Malpractice | 2.92 | × 0.899 | 2.6251 |
| Total RVUs | 25.9805 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$867.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.8 | 1.005 |
| Practice expense | 6.55 | 0.988 |
| Malpractice | 2.92 | 0.899 |
(16.8 × 1.005 + 6.55 × 0.988 + 2.92 × 0.899) × $33.4009 = $867.77
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.
58263 billing questions
When should this code be selected instead of 58262?
Use 58263 when the vaginal hysterectomy is for a uterus weighing 250 g or less, adnexal tissue is removed, and an enterocele is repaired. Code 58262 does not include the enterocele repair.
Is the enterocele repair separately reported?
The repair is included in this combination service. The operative report should document that an enterocele was repaired.
Does this code include removal of both ovaries and tubes?
It includes removal of tube(s) and/or ovary(s), so removal may involve one or both adnexa. Document which structures were removed.
Should modifier 50 be appended for bilateral adnexal removal?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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 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.
6,52758240,,Removal of pelvis contents,A,,48.10,22.25,NA,22.25,,9.82,80.17,80.17,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52858260,,Vaginal hysterectomy,A,,13.80,6.01,NA,6.01,,2.40,22.21,22.21,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,52958262,,Vag hyst including t/o,A,,15.54,6.29,NA,6.29,,2.68,24.51,24.51,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53058263,,Vag hyst w/t/o & vag repair,A,,16.80,6.55,NA,6.55,,2.92,26.27,26.27,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53158267,,Vag hyst w/urinary repair,A,,17.90,7.11,NA,7.11,,3.13,28.14,28.14,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53258270,,Vag hyst w/enterocele repair,A,,14.92,6.19,NA,6.19,,2.65,23.76,23.76,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53358275,,Hysterectomy/revise vagina,A,,16.60,6.70,NA,6.70,,2.92,26.22,26.22,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503