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CPT 57120 Fee Schedule

Last Verified: November 2025

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.

Colpoclesis Le Fort Type
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Female Genital System

Common Place of Service

22 - On Campus Outpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

51 - Multiple procedures

59 - Distinct Procedural Service

Complexity LevelModerate

National average reimbursement for CPT 57120 by major payers:

bcbs

$642.81

uhc

$693.31

aetna

$744.16

cigna

$873.10

Preview provider-level rates for...
For billing codeCPT 57120
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 57120

United
57120$3570.001891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY611917634 - (FL) ADVANCED CENTER FOR SURGERYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$2175.001558344846 - ALGONQUIN ROAD SURGERY CENTER, LLC364337493 - (IL) ALGONQUIN ROAD SURGERY CENTERILAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$3500.001437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIELAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$2054.001861487324 - DOCTORS PARK SURGERY INC431608281 - (MO) DOCTORS PARK SURGERY, INCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$2069.001104897644 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C., FOX VALLEY ORTHOPAEDIC AMBULATORY SURGICAL CENTER362796281 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C.ILAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1195.001578515995 - RAND SURGICAL PAVILLION CORP650156637 - (FL) RAND SURGICAL PAVILLION CORPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1750.001902438112 - SURGERY CENTER OF SAN DIEGO, LLC833107404 - (CA) SURGERY CENTER OF SAN DIEGO LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1180.001770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1363.001700884608 - SPRINGHILL SURGERY CENTER, DAUPHIN WEST SURGERY CENTER630982952 - (AL) SPRINGHILL SURGERY CENTERALAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1900.001740289024 - KOOTENAI OUTPATIENT SURGERY CNTR LLC, KOOTENAI OUTPATIENT SURGERY820523354 - (ID) KOOTENAI OUTPATIENT SURGERYIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$2010.001285171538 - EYE 35 ASC. LLC814995275 - (TX) EYE 35 ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$7838.001598096802 - MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC, MEMORIAL HERMANN MEMORIAL VILLAGE SURGERY CENTER264276930TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$5145.001093708315 - ASSOCIATED HEALTH SERVICES, INC., JAMES E DAVIS AMBULATORY SURGICAL CENTER561845329 - (NC) ASSOCIATED HEALTH SERVICES INCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1640.001437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC463556921 - (NC) PRIME SURGICAL SUITES LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
57120$1200.001205184603 - ST. LUKES SURGICAL AT THE VILLAGES, INC460659691 - (FL) ST LUKES SURGICAL AT THE VILLAGES INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 57120 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57120 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 57120 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.

CodeComplexityDescription
57120-CPTModerateColpoclesis Le Fort Type
57130-CPTModerateExcision Vaginal Septum
57135-CPTModerateExcision Cyst/Tumor Vagina
57150-CPTLowApplication Medicine Vagina

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57120 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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