Billing code 58145: MyomectomyMedicare rate & RVUs in Minnesota

Reports surgical removal of uterine fibroid tissue through the vagina, commonly when a leiomyoma protrudes through the cervix.

CMS RVU26DEffective Oct 1, 20261 payment locality77 Medicare services in 2024

CMS doesn’t publish an office rate for 58145 in Minnesota.

—Office (non-facility)
$468.09Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 58145 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Minnesota
  2. What 58145 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 58145 covers

Code 58145 represents surgical removal of one or more uterine fibroids through the vagina while preserving the uterus. A typical situation is a leiomyoma that has prolapsed through the cervix into the vaginal canal and can be reached for excision. A gynecologist generally performs the operation in a hospital or ambulatory surgery setting.

Choose this code for the vaginal operative route, rather than an abdominal or laparoscopic approach. The operative report should identify the fibroid and describe the vaginal route and excision performed. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this single uterine procedure. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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.

58145 in Minnesota

58145 office and facility rates by payment locality
Payment localityOfficeFacility
MinnesotaUnavailable$468.09

How the 58145 rate is calculated

Each of 58145’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 · 58145

RVUs × geographic indexes × conversion factor

Work8.69

8.69 RVUs× 1.000 GPCI

Practice expense4.74

4.74 RVUs× 1.000 GPCI

Malpractice1.51

1.51 RVUs× 1.000 GPCI

Adjusted RVUs

14.9400

Conversion factor

$33.4009

Medicare rate

$499.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 58145

58145 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58145

Myomectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.12/0.74/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 58145

Myomectomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

58145 without 51 · national facility

$499.01

Myomectomy

58145-51 · Second procedure: 50%

$249.51

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%).

When to use modifier 51

58145 compared with similar codes

Compare codes · National

5 codes, side by side

  • 58145

    Myomectomy8.69 wRVU

    Not priced

  • 58140

    Myomectomy15.4 wRVU

    Not priced

  • 58146

    Myomectomy19.83 wRVU

    Not priced

  • 58545

    Laparoscopic myomectomy15.16 wRVU

    Not priced

  • 58150

    Hysterectomy16.88 wRVU

    Not priced

How to choose

58140Myomectomy
58145 describes vaginal removal of fibroid tissue; 58140 is used for the abdominal approach.
58146Myomectomy
58146 is an abdominal myomectomy code for more extensive fibroid removal. 58145 is selected for the vaginal route.
58545Laparoscopic myomectomy
58545 describes laparoscopic myomectomy, while 58145 describes removal through the vagina.
58150Hysterectomy
58150 reports total hysterectomy, which removes the uterus; 58145 reports fibroid excision with the uterus preserved.

58145 billing questions

How is 58145 distinguished from abdominal myomectomy codes?

The defining factor is the operative route: 58145 is for vaginal excision. Abdominal myomectomy codes apply when the fibroid is removed through an abdominal incision.

Should modifier 50 be reported?

No. This is a single uterine procedure, not separate right- and left-sided work.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can another procedure be reported during the same session?

A separately performed procedure may be reported when supported, but the standard multiple-procedure reduction applies when multiple procedures are performed in the same session.

What documentation supports reporting 58145?

The operative report should identify the uterine fibroid and document that it was excised through the vaginal route.

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
RVUs for 58145PPRRVU2026_Oct_nonQPP.csv, line 6,520 (RVU26D)
Geographic factors for MinnesotaGPCI2026.csv, line 66 (RVU26D)

Open CMS sourceHow we calculate rates

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