CPT code 58560: Hysteroscopy2026 Medicare rate & RVUs in Georgia
Report this procedure when a gynecologist uses hysteroscopy to resect or divide a congenital uterine septum within the uterine cavity.
CMS doesn’t publish an office rate for 58560 in Georgia.
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 58560 covers
A gynecologist passes a hysteroscope through the cervix to visualize and surgically divide or resect a septum that partially separates the uterine cavity. The procedure is commonly performed in an operating room for a patient with a diagnosed uterine septum; it is distinct from removing an intracavitary fibroid or releasing intrauterine adhesions. The operative report should identify the septum and describe the hysteroscopic treatment performed.
Report the code for the septum procedure rather than a diagnostic-only examination or treatment directed at a different uterine finding. Documentation should support the septum diagnosis, the hysteroscopic approach, and the work completed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this service. CMS permits payment for an assistant at surgery and co-surgeons; team-surgery payment 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 58560 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $283.03 |
| Rest Of Georgia | Unavailable | $275.46 |
How the 58560 rate is calculated
Each of 58560’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 · 58560
RVUs × geographic indexes × conversion factor
Work5.61
5.61 RVUs× 1.000 GPCI
Practice expense1.62
1.62 RVUs× 1.000 GPCI
Malpractice1.00
1.00 RVUs× 1.000 GPCI
Adjusted RVUs
8.2300
Conversion factor
$33.4009
Medicare rate
$274.89
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58560
The CMS indicators that decide how 58560 is paid alongside other services.
CMS payment indicators · 58560
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 | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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
58560 without 51 · national facility
$274.89
Hysteroscopy
58560-51 · Second procedure: 50%
$137.45
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%).
58560 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 58555Hysteroscopy
- Use this code for diagnostic hysteroscopy when no operative septum treatment is performed; septum resection is a therapeutic procedure.
- 58559Hysteroscopy
- This code addresses intrauterine adhesions or scar bands. The septum code applies when the structure treated is a uterine septum.
- 58561Myoma removal
- This code is for hysteroscopic removal of a uterine fibroid. It does not describe treatment of a uterine septum.
58560 billing questions
How is septum resection different from hysteroscopic lysis of adhesions?
This code is for surgically treating a uterine septum. Use the adhesiolysis code when the procedure releases intrauterine scar bands rather than treating a septum.
Can diagnostic hysteroscopy be reported with this procedure?
When a diagnostic examination is part of the septum procedure, it should not be treated as a separate diagnostic service. If related endoscopies are performed together, CMS endoscopy family pricing applies.
Should modifier 50 be appended for a septum involving both sides of the cavity?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
What documentation supports reporting this code?
Document the uterine septum, the hysteroscopic approach, and the operative steps used to divide or resect it. The record should distinguish septum treatment from work directed at a fibroid or adhesions.
What care is included in the 0-day global period?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant or co-surgeon be paid for this procedure?
CMS permits payment for an assistant at surgery and for co-surgeons. Team-surgery payment 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 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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