CPT Code 58350 Complete Billing & Coding Guide for Corpus Uteri

Accurate coding for reproductive and fertility procedures ensures compliant billing and maximized reimbursement. CPT 58350 is used to report transcervical embryo transfer, a critical step in assisted reproductive technology (ART).

Given the procedure’s precision and its connection with complex fertility treatments, correct coding and documentation are vital for proper claim submission and reimbursement.

CPT Code 58350 – Description

Official Definition: “Transcervical embryo transfer.”

This code represents the medical procedure in which the provider transfers embryos into the uterine cavity through the cervix using a specialized catheter, typically under ultrasound guidance.

Description of the Procedure

During embryo transfer, the physician carefully inserts a soft catheter through the cervix into the uterus, guided by transabdominal ultrasound. The prepared embryo(s) are then deposited into the uterine cavity. The procedure is generally performed in an ART or IVF clinic setting under sterile conditions.

This step is crucial for achieving pregnancy following in vitro fertilization (IVF) or other assisted reproduction techniques.

Indications for Reporting CPT 58350

CPT 58350 should be reported when the provider performs the embryo transfer following laboratory fertilization. Typical indications include:

• Assisted reproductive procedures (IVF, ICSI, GIFT)
• Infertility treatment requiring embryo implantation
• Frozen embryo transfer cycles
• Donor embryo programs

When Not to Use CPT 58350

Do not report 58350 for:

• Gamete or zygote placement procedures - use CPT 58321 (GIFT) or 58322 (ZIFT).
• Artificial insemination - use CPT 58323.
• Transvaginal oocyte retrieval or aspiration - use CPT 58970.

CPT 58350 specifically applies to embryo transfer into the uterus via the cervix and should not be confused with other fertility-related procedures.

Key Billing Rules and Documentation - CPT Code 58350

• Single Procedure Code: Report 58350 once per embryo transfer session, regardless of the number of embryos transferred.
• Do Not Bill Separately: Ovum retrieval, culture, or insemination are separate laboratory services, not included under 58350.
• Ultrasound Guidance: If ultrasound guidance is performed and documented, it may be billed separately using CPT 76998 (ultrasonic guidance, intraoperative).
• E/M Services: An evaluation and management code may be reported with modifier 25 only if a significant, separately identifiable service is performed on the same date.

Site of Service and Global Period

• Typical setting: Fertility or ART clinic, ambulatory surgical center, or office procedure suite.
• Global period: None - the procedure has a 0-day global period.
• Anesthesia: Generally not required, but conscious sedation or mild analgesia may be used depending on patient comfort.

Reimbursement Information - CPT Code 58350

Based on current CMS and commercial payer data:

• Average reimbursement (facility): ~$175–$225
• Average reimbursement (non-facility): ~$150–$200
• Reimbursement varies significantly depending on payer policies and ART coverage.

Since many insurance plans have limited or no fertility coverage, patient responsibility and prior authorization should be verified before service.

Payer-Specific Tips

• Document infertility diagnosis codes such as N97.9 (Female infertility, unspecified) or Z31.83 (Encounter for assisted reproductive fertility procedure).
• Confirm payer-specific fertility treatment exclusions or limits. Some carriers require pre-authorization or documentation of prior infertility treatment failures.

Common Modifiers for CPT 58350

Modifiers clarify the context of services provided and support accurate reimbursement:

• Modifier 26 – If reporting only the professional component (for example, interpreting physician).
• Modifier 59 – If performed distinct from another reproductive procedure during the same encounter.
• Modifier 52 – When the procedure is partially completed or aborted due to clinical reasons.
• Modifier 76 – Repeat procedure by the same provider (e.g., second embryo transfer within the same cycle).

Documentation Requirements - CPT Code 58350

Thorough documentation supports medical necessity, reimbursement, and compliance with payer requirements. Ensure the operative note includes:

• Patient’s infertility diagnosis and treatment plan
• Date and time of embryo transfer
• Number and stage of embryos transferred
• Method of transfer (catheter, ultrasound guidance)
• Anesthesia or sedation details (if applicable)
• Procedure outcome and patient tolerance
• Provider signature and date

In ART billing, documentation discrepancies are among the most common causes of claim denial. Ensure the notes align with both laboratory and clinical documentation to avoid billing conflicts or compliance issues.

Example Scenarios

Scenario 1 – Standard Embryo Transfer

A patient undergoing IVF has two embryos transferred via transcervical catheter under ultrasound guidance. → Report CPT 58350 (embryo transfer).

Scenario 2 – Embryo Transfer with Ultrasound Guidance

The provider performs an embryo transfer under continuous ultrasound guidance for accurate placement. → Report CPT 58350 and CPT 76998 (ultrasound guidance), if payer allows separate billing.

Scenario 3 – Aborted Procedure

A transfer attempt is aborted due to unexpected cervical stenosis and inability to access the uterine cavity. → Report CPT 58350-52 to indicate a reduced or incomplete procedure.

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