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See a sample rate comparisonCPT 57295 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.
Rvision (Inclu Remval) Of Prosthet Vagnal Grft; Vagnal Appr, Revision (Including Removal) Of Prosthetic Vaginal Graft; Vaginal Appr
| 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 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57295 |
| Medicaid Fee Schedule | View Medicaid rates for 57295 |
National average reimbursement for CPT 57295 by major payers:
$613.73
$656.26
$674.37
$818.86
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CPT 57295
5 of 25 sample ratesHigher to lower in this preview
Surgery Center, LLC
The Surgery Center, LLC
$7,081.00Published rateSouthwest Endoscopy LLC
$2,307.00Published rateGulf Coast Outpatient Surgery Center LLC, Gulf Coast Outpatient Surgery Center
Gulf Coast Outpatient Surgery Center, LLC
$1,528.00Published rateGreece Asc, LLC, Cornerstone Surgery Center
Greece Asc LLC
$1,180.00Published ratePuget Sound Gastroenterology, PLLC, Fremont Endoscopy Center
Puget Sound Gastroenterology, P.S.
$610.00Published rate
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See a sample payer proposalCPT 57295 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57295 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 57295 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 |
| 57296-CPT | High | Rvision (Inclu Remval) Of Prosthet Vagnal Grft; Open Abdomi, Revision (Including Removal) Of Prosthetic Vaginal Graft; Open Abdomin |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57295 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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