CPT 56606 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 56606 |
National average reimbursement for CPT 56606 by major payers:
$51.84
$52.17
$54.66
$64.80
| 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 56606 | ||||||
United | 56606 | $150.00 | 1437129723 - AFFINITY OUTPATIENT SERVICES | 582189333 - (GA) AFFINITY HEALTH GROUP, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $1253.00 | 1881678662 - SURGERY AFFILIATE OF EL PASO, LLC, FOUNDATION SURGERY AFFILIATE OF EL PASO, LLC | 742797719 - (TX) SURGERY AFFILIATE OF EL PASO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $131.00 | 1609848472 - PENNSYLVANIA EYE & EAR SURGERY, PA EYE & EAR SURGERY CENTER, LLC | 300145589 - (PA) PENNSYLVANIA EYE EAR SURGERY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $223.00 | 1194832949 - CHOICES WOMEN'S MEDICAL CENTER, INC. | 112715115 - CHOICES WOMENS MEDICAL CENTER IN | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $1727.00 | 1609876556 - PEAK ONE SURGERY CENTER, LLC, PEAK ONE SURGERY CENTER | 201620230 - (CO) PEAK ONE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $500.00 | 1669621496 - CPM SURGERY CENTER 3, LLC | 263297851 - (GA) CPM SURGERY CENTER 3 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $588.00 | 1689755894 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER | 911954101 - (WA) SKIN SURGERY CENTER P. S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $115.00 | 1689133290 - MOHAWK SURGERY CENTER LLC | 830632231 - (FL) MOHAWK SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $172.00 | 1609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC | 873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $2965.00 | 1598729329 - SURGICARE OF ST ANDREWS LTD | 611276561 - (FL) SURGICARE OF ST ANDREWS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $252.00 | 1114584786 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $196.00 | 1336547421 - ASSOCIATED EYE SURGICAL CENTER LLC | 472453025 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $1551.00 | 1750415220 - TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | 751977850 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $140.00 | 1366989741 - CENTER FOR SPINE INTERVENTIONS ASC 3, LLC | 813327243 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56606 | $312.00 | 1912174996 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | MT | 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 56606 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56606 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 56606 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 |
|---|---|---|
| 56440-CPT | Moderate | Marsupialization Cyst Bartholin |
| 56441-CPT | Moderate | Lysis/Labial Adh. |
| 56515-CPT | Moderate | Destruct Condylomata Vulva Exten |
| 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 56606. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56606 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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