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CPT 57220 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.

Sphincteroplasty Urethra
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

59 - Distinct Procedural Service

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 57220 by major payers:

bcbs

$413.32

uhc

$438.86

aetna

$444.00

cigna

$563.15

Preview provider-level rates for...
For billing codeCPT 57220
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 57220

United
57220$2227.001093795031 - ARKANSAS OTOLARYNGOLOGY CENTER, P.A., AOC SURGERY CENTER, INC710411708 - (AR) ARKANSAS OTOLARYNGOLOGY CENTER, P.A.ARAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$1659.001013990308 - AUGUSTA PLASTIC SURGERY CENTER, INC.582227057 - (GA) AUGUSTA PLASTIC SURGERY CENTER INCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$8477.001740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER770573567 - (CA) PLAZA SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$3506.001194813840 - SURGERY CENTER OF WISCONSIN RAPIDS, LLC203672837 - (WI) SURGERY CENTER OF WISCONSIN RAPIDS LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$4014.001336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$1090.001578535233 - SUN CITY OPHTHALMOLOGY ASC LLC, EYE INSTITUTE AT BOSWELL621737549 - (AZ) SUN CITY OPHTHALMOLOGY ASSOC LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$5354.001740794973 - EPIC ASC, LLC, EPIC SURGERY CENTER611859657KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$1312.001255394771 - DOCTORS HOSPITAL SURGERY CENTER, L.P.861072579 - (GA) DOCTORS HOSPITAL SURGERY CENTER LPGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$1374.001730169657 - LEO R. MCCAFFERTY, M.D., SURGICAL CENTER200421646PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$2652.001528016789 - HAMILTON SURGERY CENTER L.L.C., SURGER CENTER AT HAMILTON830358914 - (NJ) HAMILTON SURGERY CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$6506.001730713439 - FLORIDA SPRINGS SURGERY CENTER LLC832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER LFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$5354.001336142413 - TEXAN AMBULATORY SURGERY CENTER, LP331058382TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$2365.001952360059 - MAINE EYE CARE ASSOCIATES, MAINE EYE CARE SURGERY CENTER10316462 - (ME) EYE CARE OF MAINE, P.A. F/K/A MAINE EYE CARE, P.A.MEAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$4463.001205030731 - PIERCE STREET SAME DAY SURGERY, LC, PIERCE STREET SAME DAY SURGERY, LC205895205 - (IA) PIERCE STREET SAME DAY SURGERYIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57220$7770.001952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLPTXAmbulatory 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 57220 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57220 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 57220 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
57200-CPTModerateColporrhaphy
57220-CPTModerateSphincteroplasty Urethra
57230-CPTModerateRepair Urethrocele
57240-CPTModerateAnterior Colporrhaphy Repair Of Cystocele With Orwithout Repair Of Urethrocele Including Cystourethroscopy When Performed (Desc Revised 1/1/2018)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57220 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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