No office rate
Use 58270 when the uterus weighs 250 grams or less and the vaginal hysterectomy includes enterocele repair; this code is for a uterus over 250 grams.
On this page
CMS RVU26D · Effective 2026-10-01
58294 Vaginal hysterectomy Medicare reimbursement rates in Kentucky
Reports vaginal removal of a uterus weighing more than 250 grams when the operation also includes repair of an enterocele. Compare 58294 office and facility rates across CMS payment localities in Kentucky.
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 58294 in Kentucky?
Kentucky 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
$1031.87
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 58294: Complex vaginal hysterectomy with enterocele repair
Reports vaginal removal of a uterus weighing more than 250 grams when the operation also includes repair of an enterocele.
A gynecologic surgeon removes the uterus through the vagina and repairs an enterocele, a protrusion of peritoneal contents into the upper vaginal area. This combination may be performed for uterine enlargement with pelvic organ prolapse. The operative report should identify the vaginal route, uterine weight, and the enterocele repair performed; document any additional procedures separately according to their operative work.
Select this code when the documented uterine weight is greater than 250 grams and the operation includes the enterocele repair. The repair is part of the combined service described by the code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 58294
- 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 RVU21.01 · 66%
- Practice expense (office) RVU7.33 · 23%
- Malpractice RVU3.68 · 11%
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.
58294 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Both describe vaginal hysterectomy for a uterus over 250 grams. This code also includes enterocele repair, while 58290 does not.
No office rate
Choose 58291 when removal of tube(s) and/or ovary(s) is part of the larger-uterus vaginal hysterectomy; use this code when the defining additional service is enterocele repair.
Compare 58294 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1031.87
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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 58294 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,539
- Code
- 58294
- Physician work
- 21.01
- Practice expense
- 7.33
- Malpractice
- 3.68
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.01 | × 1.000 | 21.0100 |
| Practice expense | 7.33 | × 0.889 | 6.5164 |
| Malpractice | 3.68 | × 0.915 | 3.3672 |
| Total RVUs | 30.8936 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1031.87
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.01 | 1 |
| Practice expense | 7.33 | 0.889 |
| Malpractice | 3.68 | 0.915 |
(21.01 × 1 + 7.33 × 0.889 + 3.68 × 0.915) × $33.4009 = $1031.87
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.
58294 billing questions
How does this differ from 58270?
Both include vaginal hysterectomy with enterocele repair. Code 58270 is for a uterus weighing 250 grams or less; this code is for a uterus weighing more than 250 grams.
Can the enterocele repair be reported separately?
The enterocele repair is included in this combined service. Do not separately report that same repair as an additional procedure.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports selecting this code?
The operative report should establish the vaginal approach, uterine weight greater than 250 grams, and the enterocele repair performed.
How is assistant or co-surgeon involvement handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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 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.
6,53658290,,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
6,54058300,,Insert intrauterine device,N,+,0.98,2.07,,0.22,,0.11,3.16,1.31,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,54158301,,Remove intrauterine device,A,,1.24,1.89,,0.28,,0.21,3.34,1.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,54258321,,Artificial insemination,A,,0.90,1.45,,0.19,,0.16,2.51,1.25,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631