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See a sample rate comparisonCPT 56631 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient 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 56631 |
| Medicaid Fee Schedule | View Medicaid rates for 56631 |
National average reimbursement for CPT 56631 by major payers:
$1,511.59
$1,547.16
$1,562.37
$1,905.17
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CPT 56631
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Southwest Ohio, LLC, The Surgery Center Of Southwest Ohio
The Surgery Center Of Southwest
$18,309.00Published rateSurgery Center Of Lancaster, Lp
Surgery Center Of Lancaster, Lp.
$9,816.00Published rateBanner Surgery Center
$6,500.00Published rateSurgical Clinic Solutions, LLC
Surgical Clinic Solutions
$4,350.00Published rateBoston Ivf, Inc., The Surgery Center Of Waltham
Boston Ivf, LLC
$1,062.00Published rate
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See a sample payer proposalCPT 56631 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56631 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 56631 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 56631. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56631 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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