2020 Hysteroscopy CPT Code Reimbursement Guide

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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