CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 58559 RVU and Medicare Payment (2026)

Hysteroscopy lysis — 5.07 work RVU, about $249.17 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
5.07
PE RVU (non-facility)
1.5
PE RVU (facility)
1.5
MP RVU
0.89
Office payment
$249.17
Facility payment
$249.17

How the payment is calculated

Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 58559 in a non-facility setting with national GPCI: (5.07 + 1.5 + 0.89) × $33.4009 ≈ $249.17. The same code in a facility setting pays about $249.17 because facility PE RVU (1.5) replaces office PE RVU.

What changes by locality

GPCI moves 58559 non-facility payment from $226.5 to $323.75 across CMS localities — from Wisconsin to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.

Related codes

Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.

Frequently asked questions

What is the 2026 work RVU for CPT 58559?

5.07. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.

How much does Medicare pay for CPT 58559 in 2026?

About $249.17 non-facility ($249.17 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.

Does the work RVU change between office and facility?

No. Work RVU (5.07) and malpractice RVU stay fixed; only practice expense changes (1.5 office vs 1.5 facility). That is the entire office-vs-facility payment gap.