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CMS RVU26D · Effective 2026-10-01

58805 Cyst drainage Medicare reimbursement rates in Massachusetts

Reports operative drainage of an ovarian cyst through an abdominal approach when the surgeon evacuates cyst contents rather than excising the cyst. Compare 58805 office and facility rates across CMS payment localities in Massachusetts.

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 58805 in Massachusetts?

Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$384.16–$411.88

2 of 2 localities have a supported rate.

Lowest: Rest Of Massachusetts

Highest: Metropolitan Boston

A spread of $27.72 per service.

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.

Find 58805 in your payment locality →

Gynecology surgery

About 58805: Ovarian cyst drainage, abdominal approach

Reports operative drainage of an ovarian cyst through an abdominal approach when the surgeon evacuates cyst contents rather than excising the cyst.

A gynecologic surgeon uses an abdominal route to reach and drain an ovarian cyst, on one or both ovaries. The service is generally performed in an operating room when the cyst is managed by drainage rather than removal of the cyst wall or ovary. The approach distinguishes this service from vaginal drainage and laparoscopic aspiration.

Choose the code based on the abdominal route and the procedure actually performed. The operative report should identify the ovarian site, approach, cyst findings, and drainage performed. CMS 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 50% reduction. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 58805

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
The code is already priced as bilateral; modifier 50 does not increase payment.
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 RVU6.26 · 55%
  • Practice expense (office) RVU4.05 · 35%
  • Malpractice RVU1.10 · 10%

22

Medicare services in 2024 · #5875 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.

58805 compared with similar codes

Office rates for Massachusetts, from the same CMS release.

58800

Ovarian cyst drainage

Vaginal approach

$359.79–$390.92

Both codes describe ovarian cyst drainage; select 58805 for an abdominal route and 58800 for a vaginal route.

49322

Laparoscopic aspiration

Cyst or cavity

No office rate

Use 49322 for laparoscopic aspiration of a cyst. 58805 represents drainage through an abdominal approach rather than laparoscopic aspiration.

58925

Ovarian cystectomy

Cyst removal, ovary preserved

No office rate

58805 drains cyst contents. 58925 is for excision of the ovarian cyst.

58820

Ovarian abscess drainage

Open approach

No office rate

58820 addresses drainage of an ovarian abscess by an open abdominal approach; 58805 is for an ovarian cyst.

Compare 58805 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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58805 billing questions

When should 58805 be chosen over 58800?

Use 58805 when the ovarian cyst is drained through an abdominal approach. Code 58800 is for drainage through a vaginal approach.

Does 58805 include cyst removal?

It represents drainage, not excision of the cyst. When the surgeon removes the cyst rather than evacuating its contents, consider the applicable cystectomy code, such as 58925.

Should modifier 50 be appended for bilateral drainage?

CMS prices 58805 as bilateral, and modifier 50 does not increase payment. Document the side or sides treated in the operative report.

How does the 90-day global period affect related visits?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Separate reporting depends on whether a service is outside the included care.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation.

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.

RVUs for 58805PPRRVU2026_Oct_nonQPP.csv, line 6,603 (RVU26D)