No office rate
Both use the vaginal route, but 58260 applies when the uterus weighs 250 grams or less; 58290 is for a uterus over 250 grams.
On this page
CMS RVU26D · Effective 2026-10-01
58290 Vaginal hysterectomy Medicare reimbursement rates in Illinois
Reports removal of an enlarged uterus through the vaginal route when its weight exceeds 250 grams and no additional coded procedure changes the service. Compare 58290 office and facility rates across CMS payment localities in Illinois.
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 58290 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1055.93–$1166.84
4 of 4 localities have a supported rate.
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 58290 pays more and less in Illinois
Gynecologic surgery
About 58290: Vaginal hysterectomy for enlarged uterus
Reports removal of an enlarged uterus through the vaginal route when its weight exceeds 250 grams and no additional coded procedure changes the service.
This code represents removal of the uterus through the vagina when the uterus weighs more than 250 grams. Gynecologic surgeons commonly perform the operation in a hospital or other surgical facility for conditions such as symptomatic fibroids or uterine prolapse when a vaginal approach is selected. The operative report should establish the route and document the uterine weight or other support for the applicable weight category.
Choose this code based on the vaginal approach and uterine weight, then check whether removal of tubes or ovaries or repair of an enterocele calls for a different sibling code. This is major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 58290
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.76 · 65%
- Practice expense (office) RVU7.06 · 23%
- Malpractice RVU3.46 · 11%
28
Medicare services in 2024 · #5713 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.
58290 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58291 when tube(s) and/or ovary(s) are also removed.
No office rate
Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58294 when the operation also includes repair of an enterocele.
Compare 58290 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$1166.84
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1109.70
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1055.93
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1111.58
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58290 billing questions
How is this code distinguished from 58260?
Both describe vaginal hysterectomy, but 58290 is for a uterus weighing more than 250 grams. Code 58260 is for a uterus weighing 250 grams or less.
When should a neighboring code replace 58290?
Use the applicable sibling when the operation also includes removal of tubes or ovaries or repair of an enterocele. The operative report should support the additional work and code selection.
Is modifier 50 appropriate?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
6,53358275,,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
6,53458280,,Hysterectomy/revise vagina,A,,17.87,6.92,NA,6.92,,3.13,27.92,27.92,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53558285,,Extensive hysterectomy,A,,22.80,11.71,NA,11.71,,5.27,39.78,39.78,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53658290,,Vag hyst complex,A,,19.76,7.06,NA,7.06,,3.46,30.28,30.28,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53758291,,Vag hyst incl t/o complex,A,,21.51,7.43,NA,7.43,,3.77,32.71,32.71,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53858292,,Vag hyst t/o & repair compl,A,,22.77,7.69,NA,7.69,,3.99,34.45,34.45,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,53958294,,Vag hyst w/enterocele compl,A,,21.01,7.33,NA,7.33,,3.68,32.02,32.02,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00