CPT 57268 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 • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57268 |
National average reimbursement for CPT 57268 by major payers:
$643.71
$655.00
$669.30
$830.29
| 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 57268 | ||||||
United | 57268 | $2388.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1968.00 | 1881339133 - BSC SHEA PARK LLC | 881850069 - (AZ) BSC SHEA PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $5438.00 | 1013548833 - ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC, ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT | 843972619 - (WI) ASCENSION WISCONSIN SURGERY CENTERMOUNT PLEASANT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1648.00 | 1477526689 - THE BLUE RIDGE CLEMSON ORTHOPAEDIC ASC LLC, BLUE RIDGE SURGERY CENTER | 621821015 - (SC) THE BLUE RIDGE CLEMSON ORTHOPAEDIC ASC LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1580.00 | 1376641670 - AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLC | 133418924 - (NY) AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2516.00 | 1679985857 - FOUNTAIN VALLEY SURGERY CENTER, LLC | 371756991 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1453.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2859.00 | 1447797105 - SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC, SOUTH DENVER SURGERY CENTER | 364821257 - (CO) SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $955.00 | 1811059306 - PENINSULA EYE CENTER, P.A, PENINSULA CATARACT & LASER CENTER | 520974706 - (MD) PENINSULA EYE CENTER PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2307.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2119.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1921.00 | 1114584786 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1954.00 | 1922076959 - BAPTIST HEALTH SURGERY CENTER LLC, BAPTIST HEALTH SURGERY CENTER AT KENDALL | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2388.00 | 1477700516 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2063.00 | 1770149304 - BLACK RIVER AMBULATORY SURGERY CENTER, LLC | 834657999 - (MO) BLACK RIVER AMBULATORY SURGERY CENTER LLC | MO | 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 57268 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57268 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 57268 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 57268. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57268 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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