CPT 56442 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Female Genital System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| CMS | $46.90 Physician Fee Schedule |
National average reimbursement for CPT 56442 by major payers:

$62.12

$63.65

$64.61

$90.90
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 56442 | ||||||
United | 56442 | $1746.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $730.00 | 1073581880 - AMBULATORY SURGERY CENTER LLC, THE CENTER FOR SAME DAY SURGERY | 481114690 - (KS) AMBULATORY SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $2174.00 | 1023218500 - SAN MARTIN SURGERY CENTER LLC | 202999408 - (NV) SAN MARTIN SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $814.00 | 1578567954 - E. RONALD SALVITTI, M.D., INC., SOUTHWESTERN PA EYE SURGERY CENTER | 251787703 - (PA) E. RONALD SALVITTI, M.D., INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1950.00 | 1639149255 - COLD SPRINGS MEDICAL SURGICAL GROUP LLC, DE LA VINA SURGICENTER | 770521530 - (CA) COLD SPRINGS MEDICAL SURGICAL GROUP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $866.00 | 1881699106 - CENTER FOR DAY SURGERY | 621845006 - (TN) CENTER FOR DAY SURGERY | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1026.00 | 1508862160 - TRIAD SURGERY CENTER LLC, TRIAD EYE MEDICAL CLINIC AND CATARACT INSTITUTE PLLC | 473510624 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $2307.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1950.00 | 1588092605 - GOLD COAST SURGERY CENTER, CENTER FOR SPECIALIZED SURGERY OF SANTA BARBARA | 460639888 - GOLD COAST SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1490.00 | 1194323725 - MISSION SURGERY CENTER LLC | 853429411 - (TX) MISSION SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $4141.00 | 1902844426 - SOUTH ARLINGTON SURGICAL PROVIDERS, LLC, SAME DAY SURGICARE | 752723958 - (TX) SOUTH ARLINGTON SURGICAL PROVIDERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1295.00 | 1427355080 - PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC, PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC | 272900107 - (GA) PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $2188.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $2307.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56442 | $1244.00 | 1528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER | 834550993 - (TN) PREMIERCOVENANT ASTC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 56442 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56442 code is part of the Surgery services used for Surgical Procedures on the Female Genital System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 56442 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56442. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56442 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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