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See a sample rate comparisonCPT 57268 Fee Schedule
Last Verified: October 2026
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.
Repair Enterocele Vaginal Appr
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 57268 |
National average reimbursement for CPT 57268 by major payers:
$643.71
$655.00
$669.30
$812.17
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CPT 57268
5 of 25 sample ratesHigher to lower in this preview
Ascension Wisconsin Surgery Center-Mount Pleasant LLC, Ascension Wisconsin Surgery Center-Mount Pleasant
Ascension Wisconsin Surgery Centermount Pleasant LLC
$5,438.00Published rateNorthwest Surgery Center, LLP, Northwest Surgery Center
Northwest Surgery Center LLP
$2,353.00Published rateBsc Shea Park LLC
$1,968.00Published rateJefferson Asc, LLC, Volunteer Surgery Center
Jefferson Asc LLC
$1,545.00Published rateCpmsc Roswell, LLC
Cpmsc Roswell LLC
$900.00Published rate
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See a sample payer proposalCPT 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 | Insert Mesh Pelvic Flr Addon, 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 | Surgery For Prolapsed Vagina, Surgery To Attach The Vagina With A Patch Graft Or Ligaments To A Bony Structure Within The Pelvis Such As The Tip Of The Sacrum. The Muscles Of A Prolapsed Vagina Can No Longer Hold It In Its Correct Position. |
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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