CPT 56515 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $268.48 Physician Fee Schedule |
National average reimbursement for CPT 56515 by major payers:

$318.55

$320.33

$351.11

$430.34
| 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 56515 | ||||||
United | 56515 | $579.00 | 1811534555 - MIDLANTIC UROLOGY SURGERY CENTER, LLC | 825347080 - (PA) MIDLANTIC UROLOGY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $1400.00 | 1063058303 - CHESAPEAKE REGIONAL SURGERY CENTER AT VIRGINIA BEACH, LLC | 843621271 - (VA) CHESAPEAKE REGIONAL SURGERY CENTER AT VIRGINIA BEACH LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $645.00 | 1730876210 - MEDICAL CITY SURGERY CENTER NORTH TEXAS, LLC | 923326615 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $753.50 | 1386604197 - SALINAS SURGERY CENTER | 770470910 - (CA) MONTEREY PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $415.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $1233.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $753.50 | 1912447418 - LUBBOCK SURGERY CENTER, LLC | 812766547 - (TX) LUBBOCK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $1500.00 | 1124247846 - ADVANCED SURGICAL ARTS CENTER LLC | 550815800 - (NJ) ADVANCED SURGICAL ARTS CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $436.00 | 1225776230 - ADVANCED AMBULATORY SURGICAL CENTER LLC | 871669738 - (KS) ADVANCED AMBULATORY SURGICAL CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $812.00 | 1811957251 - AMBULATORY SURGERY CENTER OF CENTRALIA, LLC, SURGERY CENTER OF CENTRALIA | 883961418 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $437.00 | 1548274061 - EYE INSTITUTE SURGERY CENTER, LLC | 200314591 - (FL) EYE INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $536.00 | 1609996149 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $1233.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $624.00 | 1164473922 - OPHTHALMOLOGY CENTER OF BREVARD LP, ASC OF BREVARD | 621546274 - (FL) OPHTHALMOLOGY CENTER OF BREVARD LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56515 | $994.00 | 1437597812 - VIVERE HEALTH AUSTIN, LLC, VIVERE AUSTIN SURGERY CENTER | 611694454 - (TX) VIVERE HEALTH AUSTIN LLC | TX | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 56515 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56515 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 56515 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.
| Code | Complexity | Description |
|---|---|---|
| 56501-CPT | Moderate | Destruct Les Vulva Simple, Any Meth |
| 56515-CPT | Moderate | Destruct Condylomata Vulva Exten |
| 56605-CPT | Low | Bx Vulva/Perineum 1 Lesion |
| 56606-CPT | Low | Biopsy Of Vulva Or Perineum (Separate Procedure); Each Separate Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56515 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 56515) and we'll show you how you compare in 15 minutes or less.
