CPT 58970
Global 000 ActiveRetrieval of oocyte
CPT 58970 Billing & Documentation Guide
CPT code 58970 (Retrieval of oocyte) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.43, a non-facility practice expense RVU of 3.08, and a malpractice RVU of 0.59, a total non-facility RVU of 7.1 and facility RVU of 5.17. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $241.14, though rates vary from $213.08 to $292.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 58970, 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 58970 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 58970 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 58970
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.43 | 3.43 |
| Practice Expense RVU | 3.08 | 1.15 |
| Malpractice RVU | 0.59 | 0.59 |
| Total RVU | 7.1 | 5.17 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 58970
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 | $251.09 | $174.81 | $239.83 - $286.08 | 29 |
| Florida | $256.15 | $191.46 | $242.53 - $271.5 | 3 |
| Georgia | $236.46 | $174.96 | $229.82 - $243.1 | 2 |
| Illinois | $252.03 | $189.74 | $239.29 - $263.98 | 4 |
| Michigan | $238.9 | $178.37 | $230.74 - $247.06 | 2 |
| North Carolina | $223.14 | $163 | $223.14 - $223.14 | 1 |
| New York | $261.55 | $189.64 | $226.15 - $280.81 | 5 |
| Ohio | $228.35 | $169.5 | $228.35 - $228.35 | 1 |
| Pennsylvania | $237.43 | $174.29 | $227.63 - $247.23 | 2 |
| Texas | $234.78 | $171.32 | $226.49 - $244.75 | 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 58970
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 58970 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 58970
What does CPT code 58970 mean? +
CPT code 58970 represents: Retrieval of oocyte. It's in the Surgery (Urinary/Reproductive) category with a global period of 000.
What is the Medicare reimbursement for CPT 58970? +
The 2026 Medicare national average non-facility payment for CPT 58970 is $241.14. Rates range from $213.08 to $292.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 58970? +
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 58970? +
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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