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See a sample rate comparisonCPT 56820 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.
Scope Exam Of Genitals, An Exam Of A Womans Genitals Using A Scope (Colposcopy). The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy).
| 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 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 56820 |
| Medicaid Fee Schedule | View Medicaid rates for 56820 |
National average reimbursement for CPT 56820 by major payers:
$155.17
$154.97
$166.27
$143.95
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CPT 56820
5 of 25 sample ratesHigher to lower in this preview
Alpine Surgicenter, LLC
$1,122.00Published rateDenton Regional Ambulatory Surgery Center, L.P., Medical City Surgery Center/Denton
Denton Regional Ambulatory Surgery Center Lp
$624.00Published ratePhysicians Surgery Center Of Chattanooga, LLC, Physicians Surgery Center Of Chattanooga
Physicians Surgery Center Of Chattanooga LLC
$574.00Published rateAasc, LLC, Atlanta Aesthetic Surgery Center
Surgery Center Of Atlanta
$265.00Published rateCj Elmwood Partners L P
$53.00Published rate
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See a sample payer proposalCPT 56820 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 56820 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 56820 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 |
|---|---|---|
| 56700-CPT | Moderate | Surgery On The Hymen, Surgery To Remove All Or Part Of The Membrane Covering The Vaginal Opening (Hymen). This Opens The Vagina For Normal Post-Puberty Functions Such As Menstruation Childbirth And Sex. |
| 56740-CPT | Moderate | Remove Genital Gland Or Cyst, Surgery To Remove One Or Both Bartholins Glands Which Are Located On Either Side Of The Vagina. The Procedure May Instead Remove A Cyst (Pocket Of Fluid) From The Gland. |
| 56800-CPT | Moderate | Plastic Repair Of Introitus |
| 56820-CPT | Low | Scope Exam Of Genitals, An Exam Of A Womans Genitals Using A Scope (Colposcopy). The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 56820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 56820 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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