CPT 58263: Vaginal hysterectomyMedicare rate & RVUs in Washington

Reports vaginal removal of a uterus weighing 250 g or less with removal of one or both adnexa and repair of an enterocele.

CMS RVU26DEffective Oct 1, 20262 payment localities270 Medicare services in 2024

CMS doesn’t publish an office rate for 58263 in Washington.

—Office (non-facility)
$873.02–$937.31Hospital 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 58263 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Washington
  2. What 58263 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 58263 covers

This service covers removal of the uterus through the vagina when it weighs 250 g or less, removal of one or both fallopian tubes and/or ovaries, and repair of an enterocele. Gynecologic surgeons commonly perform it for patients undergoing vaginal surgery for uterine and pelvic support conditions. The operative report should establish the vaginal route and document the adnexal removal and enterocele repair; the specimen weight supports selection of the 250-g-or-less family.

Report this combination code when all of its included work is performed. Do not separately report the adnexal removal or enterocele repair as though they were separate services. Medicare’s 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery and co-surgeon payment may be allowed; 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 58263 pays more and less in Washington

58263 office and facility rates by payment locality
Payment localityOfficeFacility
Rest Of WashingtonUnavailable$873.02
Seattle (King Cnty)Unavailable$937.31

How the 58263 rate is calculated

Each of 58263’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 · 58263

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.80Practice expense 6.55Malpractice 2.92

26.2700 adjusted RVUs×$33.4009 conversion factor=$877.44

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 58263

58263 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 58263

Vaginal hysterectomy

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)2Permitted.
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 · 58263

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

58263 without 51 · national facility

$877.44

Vaginal hysterectomy

58263-51 · Second procedure: 50%

$438.72

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

58263 compared with similar codes

Compare codes

58263 vs 58262 vs 58270 vs 58267 vs 58292: national Medicare rates

Swap in your local Medicare rate.

  • 58263
    Vaginal hysterectomy · 16.8 wRVU
    —
  • 58262
    Vaginal hysterectomy · 15.54 wRVU
    —
  • 58270
    Vaginal hysterectomy · 14.92 wRVU
    —
  • 58267
    Vaginal hysterectomy · 17.9 wRVU
    —
  • 58292
    Vaginal hysterectomy · 22.77 wRVU
    —

How to choose

58262Vaginal hysterectomy
Both include vaginal hysterectomy for a uterus of 250 g or less and adnexal removal. Choose 58263 when an enterocele is also repaired.
58270Vaginal hysterectomy
This code includes an enterocele repair but not adnexal removal. Use 58263 when tube(s) and/or ovary(s) are also removed.
58267Vaginal hysterectomy
This variant includes urinary repair rather than the enterocele repair included in 58263.
58292Vaginal hysterectomy
This is the related more complex, larger-uterus variant with adnexal removal and repair; 58263 is for a uterus weighing 250 g or less.

58263 billing questions

When should this code be selected instead of 58262?

Use 58263 when the vaginal hysterectomy is for a uterus weighing 250 g or less, adnexal tissue is removed, and an enterocele is repaired. Code 58262 does not include the enterocele repair.

Is the enterocele repair separately reported?

The repair is included in this combination service. The operative report should document that an enterocele was repaired.

Does this code include removal of both ovaries and tubes?

It includes removal of tube(s) and/or ovary(s), so removal may involve one or both adnexa. Document which structures were removed.

Should modifier 50 be appended for bilateral adnexal removal?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative care is included?

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

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 58263PPRRVU2026_Oct_nonQPP.csv, line 6,530 (RVU26D)

Open CMS sourceHow we calculate rates

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