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See a sample rate comparisonCPT 57292 Fee Schedule
Last Verified: October 2026
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.
Construction Artificial Vagina;W Graft
| 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 KX - Requirements specified in the medical policy have been met |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 57292 |
| Medicaid Fee Schedule | View Medicaid rates for 57292 |
National average reimbursement for CPT 57292 by major payers:
$1,047.12
$1,111.18
$1,170.42
$1,345.73
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CPT 57292
5 of 25 sample ratesHigher to lower in this preview
Lexington Health Inc, Lmc Northeast Asc
Lexington Health Inc
$6,632.00Published rateArizona Advanced Endoscopy LLC
Arizona Advanced Endoscopy, LLC
$3,570.00Published rateAtlanticare Surgery Center LLC
$2,211.00Published rateLutherville Surgicenter, LLC
Lutherville Surgicenter LLC
$1,471.00Published rateSpokane Digestive Disease Center, P.S., South Asc
Spokane Digestive Disease Center P.S.
$651.00Published rate
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See a sample payer proposalCPT 57292 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57292 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 57292 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 |
| 57305-CPT | High | 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 57292. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57292 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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