Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 57265 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Vaginal Wall Repair, Surgery To Repair A Muscle In The Vaginal Wall. The Procedure May Involve Moving A Bladder Or Rectum That Has Bulged Into The Vagina Back Into Its Proper Place.
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 57265 |
| Medicaid Fee Schedule | View Medicaid rates for 57265 |
National average reimbursement for CPT 57265 by major payers:
$1,085.25
$1,167.50
$1,187.93
$1,411.01
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 57265.
CPT 57265
5 of 25 sample ratesHigher to lower in this preview
Saint Francis Surgery Center, LLC, Saint Francis Surgery Center
Saint Francis Surgery Center LLC
$5,936.00Published rateBaylor Surgicare At Blue Star, LLC
Baylor Surgicare At Blue Star LLC
$4,704.00Published rateGeorgia Surgical Center On Peachtree, LLC
Georgia Surgical Center On Peachtree LLC
$3,077.00Published rateMetroeast Endoscopic Surgery Center
$2,000.00Published rateBrittany Murray
Deaconess Hospital Inc
$695.53Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 57265 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57265 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 57265 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 | Plastic Operation On Urethral, Plastic Operation On Urethral Sphincter Vaginal Approach(Eg Kelly Urethral Plication) Plastic Operation On Urethral Sphincter Vaginal Approach |
| 57230-CPT | Moderate | Surgery For Prolapsed Urethra, Surgical Repair Of A Prolapsed (Collapsed) Urethra That Is Pressing Against The Vaginal Wall. |
| 57240-CPT | Moderate | Vaginal Wall Repair, Surgery To Repair A Muscle In The Vaginal Wall. The Procedure May Involve Moving A Bladder Or Rectum That Has Bulged Into The Vagina Back Into Its Proper Place. |
| 57265-CPT | High | Vaginal Wall Repair, Surgery To Repair A Muscle In The Vaginal Wall. The Procedure May Involve Moving A Bladder Or Rectum That Has Bulged Into The Vagina Back Into Its Proper Place. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57265 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 57265) and we'll show you how you compare in 15 minutes or less.