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See a sample rate comparisonCPT 57291 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.
Construct Artificial Vagina Wo Grft
| 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 82 - Assistant surgeon - no qualified resident KX - Requirements specified in the medical policy have been met |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57291 |
| Medicaid Fee Schedule | View Medicaid rates for 57291 |
National average reimbursement for CPT 57291 by major payers:
$678.72
$739.42
$781.94
$900.48
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CPT 57291
5 of 25 sample ratesHigher to lower in this preview
Eagle Highlands Surgery Center LLC, Eagle Highlands Surgery Center
$8,705.00Published rateThe Regents Of The University Of California, Ucla Dept Of Medicine
$2,044.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$1,414.00Published rateGulf Coast Surgical Center LLC
Gulf Coast Surgical Center, LLC
$1,142.00Published rate9106 Philadelphia Road Ambulatory Surgery Center LLC
$638.00Published rate
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See a sample payer proposalCPT 57291 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57291 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 57291 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 |
|---|---|---|
| 57291-CPT | Moderate | Construct Artificial Vagina Wo Grft |
| 57292-CPT | High | Construction Artificial Vagina;W Graft |
| 57295-CPT | Moderate | Rvision (Inclu Remval) Of Prosthet Vagnal Grft; Vagnal Appr, Revision (Including Removal) Of Prosthetic Vaginal Graft; Vaginal Appr |
| 57300-CPT | Moderate | Genital Repair Surgery, Surgery To Close An Abnormal Opening Between The Vagina And Rectum. The Procedure May Include A Temporary Bypass For The Rectum (Colostomy) Or Reconstruction Of The Perineum. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57291 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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