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See a sample rate comparisonCPT 56630 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
External Genital Surgery, Surgery To Remove Cancerous Tissue That Has Advanced Deeply Into The Genital Structure. This Procedure Involves Complete Removal Of The Vulva Along With Some Deeper Tissue And Lymph Nodes. Reconstructive Surgery Will Be Required.
| 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 AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 56630 |
| Medicaid Fee Schedule | View Medicaid rates for 56630 |
National average reimbursement for CPT 56630 by major payers:
$1,147.07
$1,225.77
$1,280.59
$1,527.78
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CPT 56630
5 of 25 sample ratesHigher to lower in this preview
Alpine Surgicenter, LLC
$4,774.00Published rateMountain View Endoscopy Center Lp
Mountain View Endoscopy Center,
$2,800.00Published rateCovenant High Plains Surgery Center, LLC, Covenant High Plains Surgery Center - Quaker Avenue
Covenant High Plains Surgery Center LLC
$2,169.00Published rateBay Surgery Centers, Clearway Surgery Center Of Glen Burnie
Bay Surgery Centers
$1,334.00Published rateSouth Carolina Endoscopy Center
S.C. Endoscopy Center LLC
$602.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 56630 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56630 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 56630 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 |
|---|---|---|
| 56630-CPT | High | External Genital Surgery, Surgery To Remove Cancerous Tissue That Has Advanced Deeply Into The Genital Structure. This Procedure Involves Complete Removal Of The Vulva Along With Some Deeper Tissue And Lymph Nodes. Reconstructive Surgery Will Be Required. |
| 56631-CPT | High | External Genital Surgery, Surgery To Remove Cancerous Tissue That Has Advanced Deeply Into The Genital Structure. This Procedure Involves Complete Removal Of The Vulva Along With Some Deeper Tissue And Lymph Nodes. Reconstructive Surgery Will Be Required. |
| 56632-CPT | High | External Genital Surgery, Surgery To Remove Cancerous Tissue That Has Advanced Deeply Into The Genital Structure. This Procedure Involves Complete Removal Of The Vulva Along With Some Deeper Tissue And Lymph Nodes. Reconstructive Surgery Will Be Required. |
| 56633-CPT | High | Removal Of Female Genitals, Surgery To Remove A Womans Entire Genital Structure Including Tissue Deep In The Groin And Abdomen. The Procedure May Remove Lymph Nodes As Well. Reconstructive Surgery Will Be Required. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56630 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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