CPT 57260 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 • 80 - Assistant surgeon |
| Complexity Level | Moderate |
National average reimbursement for CPT 57260 by major payers:
$992.43
$1,035.50
$1,096.57
$1,284.74
| 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 57260 | ||||||
United | 57260 | $1190.00 | 1659408300 - CENTRE AVENUE GROUP, LLC, EAST SIDE SURGERY CENTER | 202831701 - (PA) CENTRE AVENUE GROUP, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $1265.00 | 1083670939 - CARBON SCHUYLKILL ENDOSCOPY CENTER,INC | 731662391 - (PA) CARBON SCHUYLKILL ENDOSCOPY CENTERINC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $640.00 | 1417937756 - CLEVELAND ASC LLC, CLEVELAND SURGICAL SUITES | 621647411 - (OH) CLEVELAND ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $1229.00 | 1215429030 - MEDICAL AND DENTAL CENTER OF NEVADA LLC | 825250965 - (NV) MEDICAL AND DENTAL CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $5985.00 | 1275596314 - JOHNSON COUNTY SURGERY CENTER, L.P. | 342029776 - (KS) JOHNSON COUNTY SURGERY CENTER LP | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $1725.00 | 1447442348 - TIMOTHY P. CAREY M.D. INC. P.S. | 910870414 - (WA) TIMOTHY P CAREY MD INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $6285.00 | 1558876037 - BELTWAY SURGERY CENTERS, LLC, EAST WASHINGTON SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $844.00 | 1881846137 - CENTER FOR DIGESTIVE HEALTH | 364532301 - (IL) THE CENTER FOR DIGESTIVE HEALTH, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $4248.00 | 1164448486 - CHRISTUS SANTA ROSA PASC-SAN ANTONIO LLC, CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-STONE OAK | 412092141 - (TX) CHRISTUS SRPASC - SAN ANTONIO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $713.00 | 1689646937 - OCALA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF OCALA | 621650750 - (FL) OCALA ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $1896.00 | 1467195057 - BONE AND JOINT SURGICAL SUITES, LLC | 872413013 - (FL) BONE AND JOINT SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $1550.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $19211.00 | 1285872945 - MONTEREY PENINSULA SURGERY CENTER MUNRAS AVE | 770470910 - (CA) MONTEREY PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $2204.00 | 1598412256 - GEORGIA UROLOGY, PA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57260 | $2050.00 | 1346773421 - WOMEN'S CARE FLORIDA LLC, WOMEN'S CARE FLORIDA SURGICAL CENTER | 823481913 | FL | 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 57260 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57260 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 57260 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) |
| 57260-CPT | Moderate | Combined Anteroposterior Colporrhaphy Including Cysoturethroscopy 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 57260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57260 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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