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CPT 57296 Fee Schedule

Last Verified: November 2025

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

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$4825.001528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER450516750 - (NJ) VANTAGE SURGERY CENTERNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1020.001871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY452232749 - (FL) PARAMOUNT SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$2285.001083715148 - ASC SURGICAL VENTURES, LLC, OSMC OUTPATIENT SURGERY CENTER351995261INAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$315.001265455463 - THE ENDOSCOPY CENTER AT BEL AIR470863243 - (MD) THE ENDOSCOPY CENTER AT BEL AIRMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$1681.001952516684 - POTTSTOWN HOSPITAL COMPANY LLC, POTTSTOWN MEMEORIAL MEDICAL CENTER822132538PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$443.001821565706 - LAKEWOOD ASC, LLC371912025 - (FL) LAKEWOOD ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$442.001669772893 - ADVANCED EYE SURGERY CENTER, L.L.C.273717607 - (KS) ADVANCED EYE SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$670.001609896539 - CEDAR HILLS AMBULATORY SURGERY CENTER LLC, CEDAR HILLS SURGERY CENTER680580628 - (OR) CEDAR HILLS AMBULATORY SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$500.001154996361 - CHADDS FORD AMBULATORY SURGICAL CENTER, LLC831876495 - (PA) CHADDS FORD AMBULATORY SURGICAL CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$2188.001699818237 - BON SECOURS SURGERY CENTER AT VIRGINIA BEACH LLC, BON SECOURS SURGERY CENTER AT VIRGINIA BEACH203471584 - (VA) BON SECOURS SURGERY CENTER AT VIRGINIA BEACH LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$369.001760447015 - SHEA CLINIC, SHEA CLINIC, ASC620673817 - (TN) SHEA CLINIC CORPORATIONTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$910.001316317134 - SUMMER STREET ASC LLC474990107 - (CT) SUMMER STREET ASC LLCCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$734.001366868572 - PREMIER SURGERY CENTER, LLC463321793 - (NC) PREMIER SURGERY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$991.001366154304 - OPTUM CARE WASHINGTON PLLC, OPTUM - HELEN HOLM PUMPHREY SURGERY CENTER910214500 - THE EVERETT CLINIC, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
57296$384.001457784852 - SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC, CLEARWAY SURGERY CENTER OF OWINGS MILLS454995677 - (MD) SMART PAIN SURGERY CENTER AT OWINGS MILLS LLCMDAmbulatory 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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