Price Checker / CPT 58542
CPT 58542 — Lsh w/t/o ut 250 g or less
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$733
What Medicare pays in a hospital/ASC setting
$733
What Medicare pays in a physician's office
$66,228
Based on 28 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 58542
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Franciscan Health Dyer , IN | $128,652 | $41,426 | 17440% |
| Franciscan Health Lafayette , IN | $116,282 | $29,884 | 15753% |
| Franciscan Health Michigan City , IN | $107,572 | $25,602 | 14566% |
| Franciscan Health Indianapolis , IN | $95,859 | $25,115 | 12969% |
| Memorial Hermann Sugar Land Hospital , TX | $92,104 | — | 12457% |
| "Woman's Hospital" , CA | $90,880 | $90,880 | 12290% |
| ST RITA'S MEDICAL CENTER Lima, OH | $142,438 | — | 11749% |
| Woman's Hospital , CA | $90,880 | — | 11547% |
| Franciscan Health Olympia Fields , IL | $81,064 | $16,213 | 10952% |
| Bon Secours St. Francis Xavier Hospital Inc Charleston, SC | $96,610 | — | 9611% |
| HCA FL Normandy Park ER ORANGE PARK, FL | — | — | 9137% |
| "Saint Clare's Behavioral Health - Boonton" , NJ | $65,537 | $15,304 | 8835% |
| "Saint Clare's Denville Hospital" , NJ | $65,537 | $15,304 | 8835% |
| "Saint Clare's Dover Hospital" , NJ | $65,537 | $15,304 | 8835% |
| HCA FL MARICAMP ER OCALA, FL | — | — | 8739% |
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About CPT 58542
CPT code 58542 refers to “Lsh w/t/o ut 250 g or less”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $733 in a facility (hospital or ambulatory surgery center) and $733in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.