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See a sample rate comparisonCPT 56625 Fee Schedule
Last Verified: October 2026
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.
External Genital Surgery, Surgery To Remove All Or Part Of The External Components Of A Womans Genitals In Order To Remove Precancerous Or Cancerous Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Female Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service KX - Requirements specified in the medical policy have been met |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 56625 |
| Medicaid Fee Schedule | View Medicaid rates for 56625 |
National average reimbursement for CPT 56625 by major payers:
$829.22
$842.53
$868.25
$1,059.88
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CPT 56625
5 of 25 sample ratesHigher to lower in this preview
Pearland Surgery Center, LLC
$5,729.00Published rateBanner Peoria Surgery Center LLC
$1,968.00Published rateMorganton Eye Physicians, P.A., Surgery Center Of Morganton Eye Physicians
Morganton Eye Physicians, P.A.
$1,346.00Published rateAdvanced Surgery Center Of Oxford
Oxford Surgery Center
$875.00Published rateLos Alamitos Surgery Center L P
$496.00Published rate
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See a sample payer proposalCPT 56625 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56625 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 56625 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 |
|---|---|---|
| 56515-CPT | Moderate | Destroy Vulva Lesion S Compl, Destruction Of Lesion S Vulva Extensive Eg Laser Surgery Electrosurgery Cryosurgery Chemosurgery |
| 56606-CPT | Low | Biopsy Of Vulva Or Perineum (, Biopsy Of Vulva Or Perineum (Separate Procedure)Eachseparate Additional Lesion (List Separately I N Addition To Code For Primary Procedure) |
| 56620-CPT | Moderate | External Genital Surgery, Surgery To Remove All Or Part Of The External Components Of A Womans Genitals In Order To Remove Precancerous Or Cancerous Tissue. |
| 56625-CPT | Moderate | External Genital Surgery, Surgery To Remove All Or Part Of The External Components Of A Womans Genitals In Order To Remove Precancerous Or Cancerous Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56625 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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