CPT code 58290: Vaginal hysterectomy2026 Medicare rate & RVUs in Virginia
Reports removal of an enlarged uterus through the vaginal route when its weight exceeds 250 grams and no additional coded procedure changes the service.
CMS doesn’t publish an office rate for 58290 in Virginia.
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 58290 covers
This code represents removal of the uterus through the vagina when the uterus weighs more than 250 grams. Gynecologic surgeons commonly perform the operation in a hospital or other surgical facility for conditions such as symptomatic fibroids or uterine prolapse when a vaginal approach is selected. The operative report should establish the route and document the uterine weight or other support for the applicable weight category.
Choose this code based on the vaginal approach and uterine weight, then check whether removal of tubes or ovaries or repair of an enterocele calls for a different sibling code. This is major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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 58290 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $1,102.05 |
| Virginia | Unavailable | $973.39 |
How the 58290 rate is calculated
Each of 58290’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 · 58290
RVUs × geographic indexes × conversion factor
Work19.76
19.76 RVUs× 1.000 GPCI
Practice expense7.06
7.06 RVUs× 1.000 GPCI
Malpractice3.46
3.46 RVUs× 1.000 GPCI
Adjusted RVUs
30.2800
Conversion factor
$33.4009
Medicare rate
$1,011.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 58290
58290 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58290
Vaginal hysterectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 58290
Vaginal hysterectomy
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58290 without 51 · national facility
$1,011.38
Vaginal hysterectomy
58290-51 · Second procedure: 50%
$505.69
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%).
58290 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 58260Vaginal hysterectomy
- Both use the vaginal route, but 58260 applies when the uterus weighs 250 grams or less; 58290 is for a uterus over 250 grams.
- 58291Vaginal hysterectomy
- Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58291 when tube(s) and/or ovary(s) are also removed.
- 58294Vaginal hysterectomy
- Both cover vaginal hysterectomy for a uterus over 250 grams. Choose 58294 when the operation also includes repair of an enterocele.
58290 billing questions
How is this code distinguished from 58260?
Both describe vaginal hysterectomy, but 58290 is for a uterus weighing more than 250 grams. Code 58260 is for a uterus weighing 250 grams or less.
When should a neighboring code replace 58290?
Use the applicable sibling when the operation also includes removal of tubes or ovaries or repair of an enterocele. The operative report should support the additional work and code selection.
Is modifier 50 appropriate?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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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