CPT 58900
Global 090 ActiveBiopsy of ovary(s)
CPT 58900 Billing & Documentation Guide
CPT code 58900 (Biopsy of ovary(s)) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.43, a non-facility practice expense RVU of 4.09, and a malpractice RVU of 1.13, a total non-facility RVU of 11.65 and facility RVU of 11.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $394.03, though rates vary from $351.55 to $488.44 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 58900, 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 58900 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 58900 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 58900
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.43 | 6.43 |
| Practice Expense RVU | 4.09 | 4.09 |
| Malpractice RVU | 1.13 | 1.13 |
| Total RVU | 11.65 | 11.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 58900
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 | $404.58 | $404.58 | $388.37 - $455.61 | 29 |
| Florida | $425.3 | $425.3 | $402.09 - $452.43 | 3 |
| Georgia | $390.58 | $390.58 | $381.61 - $399.54 | 2 |
| Illinois | $419.64 | $419.64 | $398.48 - $440.18 | 4 |
| Michigan | $396.17 | $396.17 | $382.1 - $410.23 | 2 |
| North Carolina | $366.34 | $366.34 | $366.34 - $366.34 | 1 |
| New York | $428.66 | $428.66 | $371.08 - $461.03 | 5 |
| Ohio | $377.54 | $377.54 | $377.54 - $377.54 | 1 |
| Pennsylvania | $390.86 | $390.86 | $375.84 - $405.87 | 2 |
| Texas | $385.5 | $385.5 | $374.15 - $404.07 | 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 58900
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 58900 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 | CPT Separate procedure definition |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
Frequently Asked Questions, CPT 58900
What does CPT code 58900 mean? +
CPT code 58900 represents: Biopsy of ovary(s). It's in the Surgery (Urinary/Reproductive) category with a global period of 090.
What is the Medicare reimbursement for CPT 58900? +
The 2026 Medicare national average non-facility payment for CPT 58900 is $394.03. Rates range from $351.55 to $488.44 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 58900? +
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 58900? +
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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