$335.50
Use 58555 for diagnostic cavity inspection without operative treatment. Adhesion division is reported with 58559, and the same-session inspection is not separately reported.
On this page
CMS RVU26D · Effective 2026-10-01
58559 Hysteroscopy Medicare reimbursement rates in Rhode Island
Report this operative hysteroscopy when the surgeon uses an instrument to divide adhesions inside the uterine cavity, such as those causing cavity distortion. Compare 58559 office and facility rates across CMS payment localities in Rhode Island.
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 58559 in Rhode Island?
Rhode Island 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
$250.83
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 58559: Hysteroscopic lysis of uterine adhesions
Report this operative hysteroscopy when the surgeon uses an instrument to divide adhesions inside the uterine cavity, such as those causing cavity distortion.
A gynecologist or other qualified surgeon uses a hysteroscope passed through the cervix to visualize and divide scar bands within the uterine cavity. This treatment may be performed for intrauterine adhesions that distort the cavity, including adhesions associated with Asherman syndrome. The procedure is commonly done in a hospital or ambulatory surgery center; it may also be performed in an appropriately equipped office setting.
Select this code when the operative work is lysis of intrauterine adhesions, not simply diagnostic inspection or treatment of a septum, myoma, polyp, or retained foreign body. The operative report should identify the adhesions and document the hysteroscopic treatment performed. 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. CMS does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is not.
CMS billing rules for 58559
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.07 · 68%
- Practice expense (office) RVU1.50 · 20%
- Malpractice RVU0.89 · 12%
183
Medicare services in 2024 · #4405 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.
58559 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$1,306.51
Use 58558 when the hysteroscopic work is biopsy or polypectomy. Use 58559 when the operative target is intrauterine adhesions.
No office rate
Use 58560 for hysteroscopic treatment of a uterine septum; 58559 addresses adhesions within the cavity.
No office rate
Use 58561 when hysteroscopy removes a uterine myoma. Adhesion lysis, rather than myoma removal, supports 58559.
Compare 58559 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$250.83
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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 58559 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,568
- Code
- 58559
- Physician work
- 5.07
- Practice expense
- 1.50
- Malpractice
- 0.89
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.07 | × 1.019 | 5.1663 |
| Practice expense | 1.50 | × 1.033 | 1.5495 |
| Malpractice | 0.89 | × 0.892 | 0.7939 |
| Total RVUs | 7.5097 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$250.83
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.07 | 1.019 |
| Practice expense | 1.5 | 1.033 |
| Malpractice | 0.89 | 0.892 |
(5.07 × 1.019 + 1.5 × 1.033 + 0.89 × 0.892) × $33.4009 = $250.83
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.
58559 billing questions
How is this different from diagnostic hysteroscopy?
This code is for operative division of adhesions inside the uterine cavity. Diagnostic hysteroscopy alone is reported with 58555; same-session diagnostic inspection is generally part of the operative hysteroscopy.
Can diagnostic hysteroscopy be billed separately on the same date?
Do not separately report 58555 for the inspection that guides the same-session adhesion treatment. The operative service includes visualization of the cavity.
Is the code reported per adhesion?
The code represents the hysteroscopic lysis service, not a unit for each adhesion or scar band. Document the findings and the treatment performed.
Should modifier 50 be used for adhesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What are the assistant and co-surgeon rules?
CMS does not pay an assistant at surgery for this service. Co-surgeons are permitted, but team surgery is not.
What global-period care is included?
The code has a 0-day global period. Same-day preoperative and postoperative care is included.
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.
6,56558554,,Laparo-vag hyst w/t/o compl,A,,22.53,8.13,NA,8.13,,4.12,34.78,34.78,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56658555,,Hysteroscopy dx sep proc,A,,2.58,6.79,,1.00,,0.45,9.82,4.03,0,000,0.00,0.00,0.00,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,56758558,,Hysteroscopy biopsy,A,,4.07,33.23,,1.33,,0.72,38.02,6.12,0,000,0.00,0.00,0.00,3,0,1,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
6,56858559,,Hysteroscopy lysis,A,,5.07,1.50,NA,1.50,,0.89,7.46,7.46,0,000,0.00,0.00,0.00,3,0,1,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
6,56958560,,Hysteroscopy resect septum,A,,5.61,1.62,NA,1.62,,1.00,8.23,8.23,0,000,0.00,0.00,0.00,3,0,2,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
6,57058561,,Hysteroscopy remove myoma,A,,6.44,1.81,NA,1.81,,1.15,9.40,9.40,0,000,0.00,0.00,0.00,3,0,0,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
6,57158562,,Hysteroscopy remove fb,A,,3.90,7.35,,1.26,,0.68,11.93,5.84,0,000,0.00,0.00,0.00,3,0,1,2,0,9,58555,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537