CPT 57250 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| 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 • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
National average reimbursement for CPT 57250 by major payers:
$763.58
$815.10
$879.97
$1,016.85
| 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 57250 | ||||||
United | 57250 | $2070.00 | 1316191430 - LAREDO DIGESTIVE HEALTH CENTER LLC | 261286495 - (TX) LAREDO DIGESTIVE HEALTH CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $578.00 | 1144326307 - OLD MOULTRIE SURGICAL CENTER INC | 593572609 - (FL) OLD MOULTRIE SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $1334.00 | 1457784852 - SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC, CLEARWAY SURGERY CENTER OF OWINGS MILLS | 454995677 - (MD) SMART PAIN SURGERY CENTER AT OWINGS MILLS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $2440.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $1002.00 | 1811933179 - KALAMAZOO ENDO CENTER LLC | 201582174 - (MI) KALAMAZOO ENDO CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $3570.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $1870.00 | 1073155834 - REGENCY AMBULATORY SURGERY CENTER ONE, LLC | 843154819 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $5015.00 | 1427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY | 223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $5202.00 | 1679943989 - LIVINGSTON ASC LLC | 474735737 - (NJ) LIVINGSTON ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $790.00 | 1255510525 - EYE SURGERY CENTER OF MICHIGAN LLC | 205795977 - (MI) EYE SURGERY CENTER OF MICHIGAN | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $2061.00 | 1831766955 - SOUTHEASTERN SURGICAL, LLC, RIVERFRONT SURGERY CENTER | 833821506 - (TN) SOUTHEASTERN SURGICAL LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $3500.00 | 1851710735 - SURGCENTER TUCSON, LLC | 462350774 - (AZ) SURGCENTER TUCSON, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $3347.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $360.00 | 1013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | 593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57250 | $957.00 | 1578679726 - SURGEYECARE, INC., SURGEYECARE GENERAL PARTNERSHIP | 752184300 | TX | 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 57250 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57250 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 57250 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 |
|---|---|---|
| 57220-CPT | Moderate | Sphincteroplasty Urethra |
| 57230-CPT | Moderate | Repair Urethrocele |
| 57240-CPT | Moderate | Anterior Colporrhaphy Repair Of Cystocele With Orwithout Repair Of Urethrocele Including Cystourethroscopy When Performed (Desc Revised 1/1/2018) |
| 57250-CPT | Moderate | Colporrhaphy Posterior |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57250 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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