Billing code 58100: Endometrial biopsyMedicare rate & RVUs in Florida
Reports office or facility sampling of the uterine lining, with or without endocervical sampling, when the clinician does not dilate the cervix.
Medicare pays $99.45–$111.05 for 58100 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 58100 covers
A clinician obtains tissue from the uterine lining for evaluation, commonly for abnormal uterine bleeding, postmenopausal bleeding, or concern for endometrial hyperplasia or cancer. The sample may be collected by aspiration or another method, and endocervical sampling may be included. Gynecologists commonly perform this procedure in an office or outpatient facility, often using a narrow sampling device passed through the cervix without dilation.
Report the service when endometrial sampling is performed without cervical dilation; documentation should identify the indication, sampling performed, and method when relevant. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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 58100 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$99.45 to $111.05
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $104.54 | $60.89 |
| Miami | $111.05 | $66.19 |
| Rest Of Florida | $99.45 | $58.26 |
How the 58100 rate is calculated
Each of 58100’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 · 58100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.18Practice expense 1.55Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 58100
The CMS indicators that decide how 58100 is paid alongside other services.
CMS payment indicators · 58100
Endometrial biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58100 without 51 · national office
$98.20
Endometrial biopsy
58100-51 · Second procedure: 50%
$49.10
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%).
58100 compared with similar codes
Compare codes
58100 vs 58120 vs 58110 vs 57500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 58120Dilation and curettage
- Choose 58100 for endometrial sampling without cervical dilation. Choose 58120 when dilation and curettage is performed.
- 58110Endometrial biopsy
- 58110 is for endometrial sampling performed with colposcopy and is an add-on to the applicable primary procedure; 58100 describes sampling without that colposcopy circumstance.
- 57500Cervical biopsy
- 58100 samples the uterine lining, while 57500 describes biopsy of cervical tissue. Select based on the tissue site sampled.
58100 billing questions
When should this code be chosen over 58120?
Use 58100 for endometrial sampling without cervical dilation. Code 58120 describes dilation and curettage, rather than sampling without dilation.
Can endocervical sampling be included?
Yes. The service may include endocervical sampling along with the uterine lining sample; document which tissue was obtained.
Should modifier 50 be appended for sampling both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports reporting 58100?
Document the clinical reason for sampling, that endometrial tissue was obtained, and that cervical dilation was not performed. Record any endocervical sampling as well.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's payment.
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
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