CPT 56640 Fee Schedule
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.
| 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 • 50 - Bilateral Procedure • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | High |
| CMS | $1,492.14 Physician Fee Schedule |
National average reimbursement for CPT 56640 by major payers:

$1,991.75

$1,984.90

$1,979.80

$2,497.86
| 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 56640 | ||||||
United | 56640 | $600.00 | 1144291923 - INTERVENTIONAL THERAPEUTICS INSTITUTE, LLC, CLEARWAY SURGERY CENTER | 830432335 - (FL) INTERVENTIONAL THERAPEUTICS INSTITUTE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $6659.00 | 1003897448 - NORTHWEST SURGERY CENTER LLC, FOOT & ANKLE SURGERY CENTER | 208754071 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $784.00 | 1871939082 - RAYMOND RENAISSANCE SURGERY CENTER LLC | 462035014 - (CA) RAYMOND RENAISSANCE SURGERY CE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $395.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $374.00 | 1336721992 - HUNTSVILLE SURGERY CENTER LLC, LASER EYE SURGERY CENTER | 825435252 - (AL) HUNTSVILLE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $838.00 | 1083946149 - METHODIST ENDOSCOPY CENTER LLC | 263765679 - (NE) METHODIST ENDOSCOPY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $800.00 | 1255896676 - ASCENTIST ASC MERRIAM, LLC, ASCENTIST EAR, NOSE AND THROAT INSTITUTE | 831973214 - (KS) ASCENTIST ASC MERRIAM LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $1039.00 | 1780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER | 205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $500.00 | 1811387368 - AUA SURGICAL CENTER, LLC | 471131186 - (TX) AUA SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $650.00 | 1619559044 - ASCENT SURGERY CENTER, LLC | 853327359 - (OH) ASCENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $580.00 | 1093748527 - WOODHAMS LASER & LENS IMPLANT CENTER LLC | 582631668 - (GA) WOODHAMS LASER LENS IMPLANT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $629.00 | 1477617751 - COLUMBIA SURGICAL SPECIALISTS, PS, COLUMBIA SURGERY CENTER | 910867604 - (WA) COLUMBIA SURGICAL SPECIALISTS, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $370.00 | 1346308962 - PODIATRY ASSOCIATES AMBULATORY SURGICAL CENTERS LLC | 522210174 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $63.00 | 1093757379 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 56640 | $700.00 | 1336510486 - SACRAMENTO HEART AMBULATORY SURGERY CENTER, INC | 475284840 - (CA) SACRAMENTO HEART AMBULATORY SURGERY CENTER INC | CA | 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 56640 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56640 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 56640 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56640 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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