CPT 58323
Global 000 ActiveSperm washing
CPT 58323 Billing & Documentation Guide
CPT code 58323 (Sperm washing) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.22, a non-facility practice expense RVU of 0.18, and a malpractice RVU of 0.04, a total non-facility RVU of 0.44 and facility RVU of 0.31. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $14.92, though rates vary from $13.2 to $18.16 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 58323, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 58323 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 58323 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 58323
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.22 | 0.22 |
| Practice Expense RVU | 0.18 | 0.05 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 0.44 | 0.31 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 58323
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $15.45 | $10.31 | $14.78 - $17.54 | 29 |
| Florida | $15.98 | $11.63 | $15.1 - $16.99 | 3 |
| Georgia | $14.69 | $10.55 | $14.3 - $15.08 | 2 |
| Illinois | $15.74 | $11.54 | $14.93 - $16.51 | 4 |
| Michigan | $14.88 | $10.8 | $14.35 - $15.4 | 2 |
| North Carolina | $13.81 | $9.76 | $13.81 - $13.81 | 1 |
| New York | $16.22 | $11.38 | $14 - $17.45 | 5 |
| Ohio | $14.18 | $10.22 | $14.18 - $14.18 | 1 |
| Pennsylvania | $14.73 | $10.48 | $14.13 - $15.33 | 2 |
| Texas | $14.55 | $10.27 | $14.06 - $15.22 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 58323
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 58323 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 58323
What does CPT code 58323 mean? +
CPT code 58323 represents: Sperm washing. It's in the Surgery (Urinary/Reproductive) category with a global period of 000.
What is the Medicare reimbursement for CPT 58323? +
The 2026 Medicare national average non-facility payment for CPT 58323 is $14.92. Rates range from $13.2 to $18.16 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 58323? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 58323? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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