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CPT 57296 Fee Schedule

Last Verified: January 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.

Open Abdominal Approach
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Female Genital System

Common Place of Service

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

51 - Multiple procedures

AS - PA/NP/CNS assistant at surgery

22 - Increased Procedural Services

80 - Assistant surgeon

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 57296

National average reimbursement for CPT 57296 by major payers:

bcbs

$1,193.22

uhc

$1,265.20

aetna

$1,258.64

cigna

$1,587.69

Preview provider-level rates for...
For billing codeCPT 57296
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 57296

United
57296$500.001154996361 - CHADDS FORD AMBULATORY SURGICAL CENTER, LLC831876495 - (PA) CHADDS FORD AMBULATORY SURGICAL CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1264.001497068761 - CARNEGIE HILL ENDOSCOPY LLC270385539 - (NY) CARNEGIE HILL ENDOSCOPY LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1169.001780791798 - LINDSAY HOUSE SURGERY CENTER LLC320178342 - (NY) LINDSAY HOUSE SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$983.001649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER201086556 - (AZ) CAMP LOWELL SURGERY CENTERAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$495.001255309951 - BAYFRONT SAME DAY SURGERY CENTER, LLC.845074208 - (FL) OHI WEST INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$850.001174588206 - CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP581709761 - (SC) CHARLESTON SURGERY CENTER LIMITED PARTNERSHIPSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1049.001720325160 - SURGCENTER OF DEER VALLEY, LLC461512703 - (AZ) SURGCENTER OF DEER VALLEY LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$983.001871751859 - WESTMINSTER SURGERY CENTER262059600 - (MD) WESTMINSTER SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$400.001437129723 - AFFINITY OUTPATIENT SERVICES582189333 - (GA) AFFINITY HEALTH GROUP, L.L.C.GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$936.001598083594 - MID-STATE ENDOSCOPY CENTER LLC270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1274.001134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CENMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$106.001447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC.OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$442.001821010638 - CATARACT AND LASER CENTER LLC522066053 - (DE) CATARACT AND LASER CENTER LLCDEAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$430.001124071550 - ANDERSEN EYE SURGERY CENTER, LLC205044851 - (MI) ANDERSEN EYE SURGERY CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$732.001427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S.WAAmbulatory 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 57296 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57296 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 57296 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
57291-CPTModerateConstruct Artificial Vagina Wo Grft
57295-CPTModerateRevision Incl Removal Of Prosthetic Vaginal Graft Vaginal Approach
57296-CPTHighOpen Abdominal Approach
57305-CPTHighFistulectomy Rectovaginal Abd Appr

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57296. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57296 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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