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CPT 57289 Fee Schedule

Last Verified: November 2025

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.

Pereyra Procedure
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Female Genital System

Common Place of Service

24 - Ambulatory Surgical Center

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 57289 by major payers:

bcbs

$946.18

uhc

$1,025.63

aetna

$1,026.98

cigna

$1,288.44

Preview provider-level rates for...
For billing codeCPT 57289
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 57289

United
57289$1181.471275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC610701663 - (KY) DERMATOLOGY ASSOCIATES OF KENTUCKY, P.S.C.KYAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1124.001992701049 - NORTHWEST FLORIDA SURGERY CENTER593123289 - (FL) NORTHWEST FLORIDA SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$3570.001932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE821568426AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$2717.001477584621 - HANOVER NJ ENDOSCOPY ASC LLC, HANOVER ENDOSCOPY CENTER201272329 - (NJ) HANOVER NJ ENDOSCOPY ASC LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1300.001871529388 - PRG DALLAS ASC, LLC, CENTRAL POINT SURGERY CENTER752835144TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$3155.001154945921 - MONTANA ENDOSCOPY CENTER, PLLC843703860 - (MT) MONTANA ENDOSCOPY CENTER PLLCMTAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$2325.001710127774 - NORTHERN CALIFORNIA ADVANCED SURGERY CENTER LP264264927 - (CA) NORTHERN CALIFORNIA ADVANCED SURGERY CENTER, LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1222.001972568830 - FLORENCE SURGERY CENTER, L.P., FLORENCE SURGERY CENTER621551098 - (AL) FLORENCE SURGERY CENTER LPALAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1423.001073675583 - ROCKVILLE ESC NORTH MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND208004241MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$2281.001093444010 - SUMMIT MEDICAL GROUP PA223487984 - SUMMIT MEDICAL GROUP, P.A.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$6632.001396342838 - LEXINGTON HEALTH INC, LMC IRMO ASC852276567 - LEXINGTON HEALTH INCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1375.001306135298 - DMG PAIN MANAGEMENT SURGERY CENTER, LLC271322187 - (IL) DMG PAIN MANAGEMENT SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$1376.001134182546 - JACKSONVILLE SURGERY CENTER, LTD621600402 - (FL) JACKSONVILLE SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$3500.001891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY611917634 - (FL) ADVANCED CENTER FOR SURGERYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57289$2552.001649682014 - ENTI SURGERY CENTER LLC462334845 - (GA) ENTI SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 57289 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57289 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 57289 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.

CodeComplexityDescription
57283-CPTModerateColpopexy, Vaginal; Intra-Peritoneal Approach (Uterosacral, Levator Myorrhaphy)
57284-CPTHighParavaginal Defect Repair
57285-CPTModerateRepair Paravag Defect, Vag
57289-CPTModeratePereyra Procedure

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57289. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57289 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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