58558
Hysteroscopy with Biopsy Female
Our Work > Good Faith Estimates > Hysteroscopy Biopsy
Recent regulations require hospitals and health plans to publish prices of a subset of services. The hospital rule requires publication of “shoppable services,” those that can be scheduled in advance by a consumer. The Transparency in Coverage rule requires a list of 500 items and services to be published. Hysteroscopy with Biopsy Female appears on both lists, and there is a standard service package available for it.
Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. In some cases, a small sample of tissue from the womb lining may be removed for further testing. This is known as an endometria biopsy.
Your service utilization may vary from this service package for a number of reasons, including your unique clinical profile and where you receive your services.
This Service Package was generated using outpatient care setting. However, this service package may also be performed in the below care settings. Please confirm with your provider in which care setting you will receive services, as this may affect your cost.
- Inpatient: XX%
- Outpatient facility: XX%
- Free standing ASC: XX%
- Office: XX%
Item Definitions
Index
Index
this is the fee for the service being defined; note that other codes may be used to define a similar service
Facility Fee
Facility Fee
these fees are most commonly associated with the index event; these may also be
paid to the facility in addition to the index fee
Professional Fee
Professional Fee
these fees are paid to clinicians for the work associated with this service
Optional Fee
Optional Fee
these services are often also billed with the index event, however may vary based on the patient’s individual circumstances
Ancillary Service
Ancillary Service
these are supply codes that identify other services that may be billed with the index event
Proposed Technical Definition
| association | base_code | code_type | estimated_charge | id | item_type | modifier | name |
|---|---|---|---|---|---|---|---|
| 1 | 58558 | CPT | 8419.18 | 14450 | index | Hysteroscopy with biopsy Female | |
| 1 | 58558 | CPT | 4038.94 | 15130 | professional_fee | J1 | Hysteroscopy with biopsy Female |
| 0.931690141 | 710 | Revenue Code | 14451 | ancillary_service | Recovery Room | ||
| 0.914084507 | 88305 | CPT | 1568.01 | 14452 | facility_fee | Surgical Pathology Level 4 | |
| 0.847887324 | 370 | Revenue Code | 14453 | ancillary_service | Anesthesia | ||
| 0.833 | 88305 | CPT | 404.25 | 15131 | professional_fee | Q1 | Surgical Pathology Level 4 |
| ancillary_servi | Pharmacy | ||||||
| 0.807042254 | 250 | Revenue Code | 14454 | ce | |||
| 0.748591549 | J3010 | HCPCS | 78.72 | 14455 | facility_fee | Fentanyl Injection | |
| 0.744366197 | J2405 | HCPCS | 67.28 | 14456 | facility_fee | Anti-Nausea Medication | |
| 0.725 | 952 | CPT | 1054.34 | 15132 | professional_fee | N | Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography |
| 0.671830986 | J2704 | HCPCS | 164.22 | 14457 | facility_fee | Propofol Injection | |
| 0.602112676 | 272 | Revenue Code | 14458 | ancillary_service | Sterile supplies | ||
| 0.513380282 | J1100 | HCPCS | 81.28 | 14459 | facility_fee | Dexamethasone | |
| 0.376760563 | 270 | Revenue Code | 14461 | ancillary_service | Medical/Surgical Supplies and Devices | ||
| 0.371830986 | J1885 | HCPCS | 89.7 | 14462 | facility_fee | Anti-Inflammatory Drug | |
| 0.344366197 | J7120 | HCPCS | 295.26 | 14463 | facility_fee | Lactated Ri |
Captured Spending (N=70,000)
| Decile | Base Fee (Facility + Professional) | Base Fee + Optional Fees |
| 1 | 2% | |
| 2 | 1% | |
| 3 | 2% | |
| 4 | 2% | |
| 5 | 2% | |
| 6 | 3% | |
| 7 | 4% | |
| 8 | 5% | |
| 9 | 6% | |
| 10 | 74% |
Our Work > Good Faith Estimates > Hysteroscopy Biopsy