How much does Medicare pay for CPT 58542?

Medicare allowed an average of $432.12 per service and paid $344.42 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3100.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 58542?

Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, 250.0 g or less. It was billed 1,356 times to 1,354 Medicare beneficiaries by 78 providers in 2024.

Which specialty bills 58542 most?

Obstetrics & Gynecology, with 831 services from 50 clinicians. Next are Physician Assistant, Urology, Ambulatory Surgical Center.

CPT 58542

Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, 250.0 g or less

$432.12Medicare-allowed amount per service, averaged across 1,356 services

Providers submitted

$3100.54

Asking price, not received

Medicare allowed

$432.12

The fee schedule figure

Medicare paid

$344.42

Balance is patient coinsurance

Providers submitted an average of $3100.54 for this code and Medicare allowed $432.12 — 7.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $344.42 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,356
Beneficiaries: 1,354
Providers billing it: 78
Total allowed: $585,955

What Medicare pays for CPT 58542

Across 1,356 services billed by 78 providers to 1,354 beneficiaries, Medicare allowed an average of $432.12 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 58542

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	831	830	$457.68	50
Physician Assistant	233	233	$58.59	13
Urology	226	225	$386.80	11
Ambulatory Surgical Center	22	22	$4104.58	1
Undefined Physician type	15	15	$473.55	1
Gynecological Oncology	15	15	$419.82	1
Nurse Practitioner	14	14	$61.20	1

58542 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	187	$379.83	$244.33	11
California	176	$337.85	$251.65	10
Florida	154	$871.00	$724.16	9
New Jersey	142	$358.56	$257.39	6
Texas	95	$403.08	$320.83	5
Pennsylvania	78	$386.98	$293.59	3
Indiana	59	$390.04	$329.09	3
North Carolina	43	$421.79	$245.20	3
Nebraska	41	$284.87	$252.23	3
South Carolina	40	$263.30	$219.66	2
Minnesota	37	$266.16	$236.37	3
South Dakota	36	$220.25	$184.65	2
Mississippi	33	$230.74	$198.10	2
Virginia	31	$411.44	$325.10	2
Illinois	30	$448.68	$325.05	2
Ohio	25	$396.71	$341.31	2
Maryland	24	$453.74	$324.70	1
Missouri	17	$793.95	$344.42	1
Delaware	16	$644.94	$440.84	1
Oklahoma	14	$440.97	$371.59	1
Arizona	14	$801.48	$396.44	1
Colorado	13	$765.58	$355.20	1
Tennessee	13	$377.00	$325.65	1
Nevada	13	$430.69	$375.06	1
Connecticut	13	$71.06	$44.18	1
Alaska	12	$298.36	$188.77	1

Related codes

58571Removal of uterus$691.64
58558Biopsy of lining of uterus and/or removal of polyp$907.32

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.