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58559

Active0-day global

Hysteroscopy lysis

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.

Show values as
Modifiers
LineQtyNon-facility (office)Facility (hospital/ASC)
585591$249.17$249.17
Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF

RowWork RVUPE RVU (office)PE RVU (facility)MP RVUTotal (office)
585595.071.501.500.897.46

Payment policy for 58559

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=3

Endoscopy rule

Special multiple-endoscopy rules apply within the same endoscopy family, then standard ranking.

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=1

Not payable

Assistant at surgery may not be paid for this procedure.

Co-surgeons (modifier 62)

co_surg=2

Payable

Co-surgeons (mod 62) are paid 62.5% of the fee each (125% total, split).

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.

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