2020 Hysteroscopy CPT Code Reimbursement Guide
[Pages:4]Gynecology Procedures
2020 Coding and Reimbursement Guide
Hysteroscopy reimbursement varies by geographical location and the individual rules of the payer. KARL STORZ provides this coding and payment guide for information purposes only. KARL STORZ does not guarantee or warrant that the use of this information will result in payment or coverage. Actual codes used are at the sole discretion of the treating physicians and facility. You should consult the individual payers to determine the current reimbursement profiles and their rules for capturing additional costs associated with performing a procedure.
2020 Gynecology Procedures ? Global and Physician Professional Payment
CPT/ HCPCS
Description
58340 58353
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography
Endometrial ablation, thermal, without hysteroscopic guidance
58555 Hysteroscopy, diagnostic (separate procedure)
58558 58559
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
Hysteroscopy, surgical with lysis of intrauterine adhesions (any method)
58560
Hysteroscopy, surgical with division or resection of intrauterine septum (any method)
58561
Hysteroscopy; surgical; with removal of leiomyomata
58562 58563 58565 58579
Hysteroscopy, surgical with removal of impacted foreign body
Hysteroscopy; surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
Hysteroscopy, surgical with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants
Unlisted hysteroscopy procedure, uterus
Additional Procedure Codes
58300 Insertion of intrauterine device (IUD)
58301 Removal of intrauterine device (IUD)
Ultrasound Procedure Codes
74740
Hysterosalpingography, radiological supervision and interpretation
76830 Ultrasound; transvaginal
76831
Saline infusion sonohysterography (SIS), including color flow Doppler, when performed
RVU
Office
Facility
(Global) (Professional)
National Average Medicare Rate
Office
Facility
(Global) (Professional)
5.53
1.65
$199.58
$59.55
28.51 9.26 39.61 8.33 9.16 10.48 11.31 55.61
6.54 4.42 6.74 8.33 9.16 10.48 6.47 7.18
$1,028.91 $334.19 $1,429.51
$236.03 $159.52 $243.24
$300.63 $330.58 $378.22 $408.17
$300.63 $330.58 $378.22 $233.50
$2,006.94
$259.12
51.65 0.00
12.97 0.00
$1,864.03 N/A
$468.08 N/A
2.60
1.49
$93.83
$53.77
2.91
1.95
$105.02
$70.37
2.54
2.54
$91.67
$91.67
3.47
3.47
$125.23
$125.23
3.36
3.36
$121.26
$121.26
The national average 2020 Medicare rates to physicians shown are based on the 2020 conversion factor of $36.0896. Medicare payment for a specific procedure and specific geographical location should be available in the Medicare Physician Fee Schedule file accessible through the CMS website. Payment rates listed may be subject to change without notice.
2020 Gynecology Procedures ? Facility Payment
CPT/ HCPCS
58340
Description
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography
58353
Endometrial ablation, thermal, without hysteroscopic guidance
58555 Hysteroscopy, diagnostic (separate procedure)
58558
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
58559
Hysteroscopy, surgical with lysis of intrauterine adhesions (any method)
58560
Hysteroscopy, surgical with division or resection of intrauterine septum (any method)
58561 Hysteroscopy; surgical; with removal of leiomyomata
58562 58563 58565
Hysteroscopy, surgical with removal of impacted foreign body
Hysteroscopy; surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
Hysteroscopy, surgical with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants
58579 Unlisted hysteroscopy procedure, uterus
Additional Procedure Codes
58300 Insertion of intrauterine device (IUD)
58301 Removal of intrauterine device (IUD)
Ultrasound Procedure Codes
74740
Hysterosalpingography, radiological supervision and interpretation
76830 Ultrasound; transvaginal
76831
Saline infusion sonohysterography (SIS), including color flow Doppler, when performed
Site of Service
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
Hospital ASC
National Average Medicare Rate no info available no info available $4,271.07 $1,816.36 $2,497.83 $1,235.31 $2,497.83 $1,235.31 $4,271.07 $1,816.36 $4,271.07 $1,816.36 $4,271.07 $1,816.36 $2,497.83 $1,235.31 $4,271.07 $1,816.36 $4,271.07 $1,816.36 $166.03 N/A
N/A N/A $270.69 $52.33
$233.01 packaged $112.07
$56.63 $233.01 $84.09
The national average 2020 Medicare rates to physicians shown are based on the 2020 conversion factor of $36.0896. Medicare payment for a specific procedure and specific geographical location should be available in the Medicare Physician Fee Schedule file accessible through the CMS website. Payment rates listed may be subject to change without notice.
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97121017 GYN 1 1.0 us 01/2020/MFL-E-US
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