Billing code 58356: Endometrial ablationMedicare rate & RVUs in Texas
Reports destruction of the uterine lining by cryotherapy, including intraoperative ultrasound guidance and monitoring, for selected patients with abnormal uterine bleeding.
Medicare pays $1,490.60–$1,692.36 for 58356 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 58356 covers
A gynecologist uses a cryoprobe to freeze and destroy the endometrial lining as a treatment for abnormal uterine bleeding, often heavy menstrual bleeding. The procedure is generally performed in an outpatient setting after evaluation of the bleeding and confirmation that endometrial ablation is an appropriate treatment. The code includes intraoperative ultrasound guidance and monitoring used during the cryoablation.
Report the service when cryotherapy is the method used; do not select it for thermal ablation or hysteroscopic ablation. The record should support the bleeding indication, the cryoablation technique, and the work performed. Related postoperative visits during the 10-day global period 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 reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available and co-surgeons are permitted; 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.
Where 58356 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$1490.60 to $1692.36
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $1,692.36 | $305.33 |
| Beaumont | $1,490.60 | $297.60 |
| Brazoria | $1,597.85 | $298.66 |
| Dallas | $1,607.78 | $302.04 |
| Fort Worth | $1,594.55 | $301.92 |
| Galveston | $1,602.36 | $300.55 |
| Houston | $1,622.49 | $320.68 |
| Rest Of Texas | $1,543.11 | $298.99 |
How the 58356 rate is calculated
Each of 58356’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 · 58356
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.25Practice expense 41.05Malpractice 1.10
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 58356
58356 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58356
Endometrial ablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 58356
Endometrial ablation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58356 without 51 · national office
$1,616.60
Endometrial ablation
58356-51 · Second procedure: 50%
$808.30
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%).
58356 compared with similar codes
Compare codes
58356 vs 58353 vs 58563 vs 58300: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 58353Thermal ablation
- Choose 58356 for cryotherapy with intraoperative ultrasound guidance and monitoring; choose 58353 when the endometrium is ablated thermally.
- 58563Hysteroscopy
- 58563 describes endometrial ablation performed hysteroscopically. 58356 identifies cryoablation with ultrasound guidance and monitoring.
- 58300Insert intrauterine device
- 58300 reports insertion of an intrauterine device, not destruction of the endometrial lining by cryotherapy.
58356 billing questions
How does 58356 differ from 58353?
58356 is for endometrial destruction by cryotherapy and includes intraoperative ultrasound guidance and monitoring. Use 58353 for thermal endometrial ablation instead.
Can the intraoperative ultrasound be reported separately?
The code includes intraoperative ultrasound guidance and monitoring for the cryoablation; those elements are not separately reported as additional services for this procedure.
Should modifier 50 be appended?
No. The uterine target is not treated as a bilateral service for this code, and the CMS bilateral adjustment does not apply.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. Related postoperative visits for 10 days are included in this code's global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available, and co-surgeons are permitted. Team surgery is not permitted for this code.
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
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