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 |
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 | $1379.00 | 1962772871 - SURGERY CENTER OF NORTHEAST TEXAS LLC, SURGERY CENTER OF NORTHEAST TEXAS | 454184639 - (TX) SCNETX, LLCDBA SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1472.00 | 1588938682 - WEST SIDE GI, LLC | 271185812 - (NY) WESTSIDE GI CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1399.00 | 1417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE | 412081861 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1348.00 | 1629517800 - NORTHWEST SURGERY CENTER, LLC | 352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLAN | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2307.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2353.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2516.00 | 1679985857 - FOUNTAIN VALLEY SURGERY CENTER, LLC | 371756991 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1530.00 | 1609965961 - BROOKINGS AMBULATORY SURGERY CENTER, LLP | 203272258 - (SD) BROOKINGS AMBULATORY SURGERY CENTER LLP | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2353.00 | 1245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC | 845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1514.00 | 1194047092 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $2621.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $912.41 | 1033190129 - MAE PHYSICIANS SURGERY CENTER, LLC | 640914895 - (MS) MAE PHYSICIAN'S SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1148.00 | 1922068295 - ARKANSAS SURGERY AND ENDOSCOPY CENTER, INC, ASEC | 710781297 - (AR) ARKANSAS SURGERY AND ENDOSCOPY CENTER INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $965.00 | 1265438303 - EYE SURGERY CENTER OF CHATTANOOGA, LLC | 200149350 - (TN) EYE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57268 | $1111.00 | 1306503057 - PAIN CARE SURGERY OF LOUISVILLE, LLC | 844317137 - (KY) PAIN CARE SURGERY OF LOUISVILLE LLC | KY | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 57268) and we'll show you how you compare in 15 minutes or less.