CPT 57280 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Female Genital System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 80 - Assistant surgeon |
| Complexity Level | High |
National average reimbursement for CPT 57280 by major payers:
$1,210.28
$1,285.61
$1,268.46
$1,590.65
| 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 57280 | ||||||
United | 57280 | $1283.00 | 1215185335 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1505.00 | 1770076010 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC ASC SAFFORD | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $4707.00 | 1396342838 - LEXINGTON HEALTH INC, LMC IRMO ASC | 852276567 - LEXINGTON HEALTH INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1240.00 | 1750884052 - PRECISION SURGERY CENTER PLLC | 824729968 - (ID) PRECISION SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2307.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2844.00 | 1386387116 - MADISON SURGICENTER LLC | 881205721 - (WI) MADISON SURGICENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2289.00 | 1356412894 - ROCKFORD ORTHOPEDIC SURGERY CENTER, LLC | 364513047 - (IL) ROCKFORD ORTHOPEDIC SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $858.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2901.00 | 1053418137 - TRI-CITY REGIONAL SURGERY CENTER LLC | 911728399 - (WA) TRI-CITY REGIONAL SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2795.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1047.00 | 1255911970 - PINNACLE SURGERY CENTER | 842367400 - (LA) PINNACLE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $2388.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1000.00 | 1891313532 - ROCKINGHAM EYE SURGERY CENTER, LLC | 842294161 - (VA) ROCKINGHAM EYE SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1088.00 | 1609874254 - NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC | 223871351 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57280 | $1564.00 | 1699054098 - SURGCENTER OF WESTERN MARYLAND, LLC | 272969860 - (MD) SURGCENTER OF WESTERN MARYLAND, LLC | MD | 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 57280 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57280 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 57280 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 57280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57280 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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