Billing code 58555: HysteroscopyMedicare rate & RVUs in Florida
Reports hysteroscopic inspection of the uterine cavity for diagnostic evaluation when no biopsy, tissue removal, or other operative hysteroscopic service is performed.
Medicare pays $325.58–$360.28 for 58555 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 58555 covers
A gynecologist passes a hysteroscope through the cervix to inspect the endometrial cavity, for example when evaluating abnormal uterine bleeding or a suspected intracavitary abnormality. The procedure may be performed in an office or outpatient surgical setting. This code represents diagnostic visualization, not hysteroscopic sampling or treatment of a finding.
Report it when diagnostic inspection is the hysteroscopic service performed; document the indication, findings, and whether any operative work was done. Because it is a separate procedure, diagnostic inspection is generally not separately reported when it is part of a hysteroscopic biopsy or treatment. The 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced by 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, while team surgery is 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 58555 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
$325.58 to $360.28
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $343.09 | $147.18 |
| Miami | $360.28 | $158.96 |
| Rest Of Florida | $325.58 | $140.70 |
How the 58555 rate is calculated
Each of 58555’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 · 58555
RVUs × geographic indexes × conversion factor
Work2.58
2.58 RVUs× 1.000 GPCI
Practice expense6.79
6.79 RVUs× 1.000 GPCI
Malpractice0.45
0.45 RVUs× 1.000 GPCI
Adjusted RVUs
9.8200
Conversion factor
$33.4009
Medicare rate
$328.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58555
The CMS indicators that decide how 58555 is paid alongside other services.
CMS payment indicators · 58555
Hysteroscopy
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 2 | 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
58555 without 51 · national office
$328.00
Hysteroscopy
58555-51 · Second procedure: 50%
$164.00
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%).
58555 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 58558Hysteroscopy
- Choose 58555 when the hysteroscope is used for diagnostic inspection only. Choose 58558 when the hysteroscopic service includes endometrial sampling or biopsy.
- 58559Hysteroscopy
- 58559 describes operative hysteroscopic lysis of intrauterine adhesions; 58555 describes inspection without that treatment.
- 58561Myoma removal
- Use 58561 for hysteroscopic removal of a uterine myoma. Diagnostic visualization without myoma removal is represented by 58555.
58555 billing questions
When should 58555 be chosen instead of 58558?
Use 58555 for diagnostic cavity inspection without sampling or tissue removal. When hysteroscopy includes endometrial sampling or biopsy, 58558 describes the operative service.
Can 58555 be reported with an operative hysteroscopy code?
The diagnostic inspection is generally integral to hysteroscopic biopsy or treatment and is not separately reported for the same procedure. Report the code describing the operative work performed.
What documentation supports 58555?
Document the clinical reason for evaluating the cavity, the hysteroscopic findings, and that no biopsy or therapeutic work was performed.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.
When is assistant-at-surgery payment allowed?
Payment for an assistant at surgery requires documentation of medical necessity. CMS permits co-surgeons but does not permit team surgery for this code.
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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