Billing code 58546: Laparoscopic myomectomyMedicare rate & RVUs in Washington
Reports laparoscopic removal of uterine fibroids at the complex level, based on the number of intramural myomas removed or their total weight.
CMS doesn’t publish an office rate for 58546 in Washington.
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 58546 covers
A gynecologic surgeon removes uterine fibroids through a laparoscopic approach while preserving the uterus, typically in an operating room. This complex level is selected when the operation involves five or more intramural myomas or the removed myomas meet the 250-gram weight threshold. The surgeon may make incisions in the uterus to remove the fibroids and repair the uterine wall; the operative report should describe the approach and work performed.
Select the level using the documented number of intramural myomas and the total weight of the excised tissue. Record both when available, along with the sites treated, so the basis for this level is clear. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 and co-surgeon payment may be allowed; team-surgery payment is not permitted. Modifier 50 is not appropriate for this uterine procedure.
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 58546 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $972.44 |
| Seattle (King Cnty) | Unavailable | $1,040.54 |
How the 58546 rate is calculated
Each of 58546’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 · 58546
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.44Practice expense 6.49Malpractice 3.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 58546
58546 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 58546
Laparoscopic myomectomy
| 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) | 2 | Permitted. |
| 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 · 58546
Laparoscopic 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
58546 without 51 · national facility
$979.65
Laparoscopic myomectomy
58546-51 · Second procedure: 50%
$489.83
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%).
58546 compared with similar codes
Compare codes
58546 vs 58545 vs 58561 vs 58572: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 58545Laparoscopic myomectomy
- Both describe laparoscopic myomectomy. Choose 58546 for five or more intramural myomas or when the total excised weight meets its threshold; 58545 represents the lower level.
- 58561Myoma removal
- 58561 is hysteroscopic removal of a uterine myoma through the uterine cavity. 58546 is laparoscopic myomectomy, not hysteroscopic treatment.
- 58572Laparoscopic hysterectomy
- 58572 reports total laparoscopic hysterectomy for a uterus over 250 g. It applies when the uterus is removed, unlike 58546, which removes myomas while preserving the uterus.
58546 billing questions
How is this code distinguished from 58545?
Use this complex level when five or more intramural myomas are removed or the total excised weight meets the 250-gram threshold. Code 58545 describes the lower myomectomy level.
What documentation supports the complex level?
The operative report should describe the laparoscopic approach and the myomectomy performed. Document the number of intramural myomas removed and the total excised weight to support the level selected.
Can a separate hysteroscopic myomectomy be reported?
A hysteroscopic removal, such as 58561, is a different approach used for myomas treated through the uterine cavity. Do not report it for the same work already included in the laparoscopic myomectomy.
Is modifier 50 appropriate?
No. Modifier 50 is not appropriate for this uterine procedure under the CMS bilateral adjustment rule.
How does the 90-day global period affect follow-up visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are not separately reported as routine visits.
Can an assistant or co-surgeon be paid?
CMS permits assistant-at-surgery and co-surgeon payment for this code. Team-surgery payment is not permitted.
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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