CPT 57267 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 • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57267 |
National average reimbursement for CPT 57267 by major payers:
$360.75
$348.33
$335.42
$430.82
| 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 57267 | ||||||
United | 57267 | $166.00 | 1316231020 - DESERT VIEW ENDOSCOPY CENTER, LLC. | 272420135 - (CA) DESERT VIEW ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $200.00 | 1487187076 - GREEN VALLEY SURGERY CENTER LLC | 812240255 - (NV) GREEN VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $566.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $125.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $312.00 | 1215178835 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $162.00 | 1740823848 - KING OF PRUSSIA SURGERY CENTER, LLC, KING OF PRUSSIA SURGERY CENTER | 832782091 - (PA) KING OF PRUSSIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $403.00 | 1093088999 - CHIPPENHAM AMBULATORY SURGERY CENTER, LLC | 371587067 - (VA) CHIPPENHAM AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $700.00 | 1679605729 - METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC | 222306421 - (NJ) METROPOLITAN SURGICAL ASSOCIATES, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $390.00 | 1124055165 - SALINA UROLOGY CARE CENTER LLC | 522407155 - (KS) SALINA UROLOGY CARE CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $60.00 | 1962455428 - VALLEY EYE INSTITUTE ASC LLC, CVP SURGERY CENTER | 200080762 - (OH) VALLEY EYE INSTITUTE ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $226.00 | 1902964174 - 4TH STREET LASER & SURGERY CENTER INC | 943333271 - (CA) FOURTH STREET LASER & SURGERY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $217.00 | 1679696157 - ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES, LLC, SLOCUM AMBULATORY SURGERY CENTER | 770590285 - (OR) ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $169.00 | 1053496240 - OAKLAND CA ENDOSCOPY ASC LP, EAST BAY ENDOSURGERY CENTER | 205645928 - (CA) OAKLAND CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $74.00 | 1548844384 - GUT ENDO, LLC, CENTER FOR DIGESTIVE HEALTH | 834462225 - (AL) GUT ENDO, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57267 | $202.00 | 1295279586 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (NAPLES BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | 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 57267 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57267 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 57267 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 |
|---|---|---|
| 57267-CPT | Moderate | Insertion Of Mesh Or Other Prosthesis For Repair Of Pelvic Floor Defect, Each Site (Anterior, Posterior Compartment), Vaginal Approach (List Separately In Addition To Code For Primary Procedure) |
| 57268-CPT | Moderate | Repair Enterocele Vaginal Appr |
| 57270-CPT | High | Repair Enterocele,Abdominal Approach |
| 57280-CPT | High | Colpopexy Abdominal Appr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57267. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57267 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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