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See a sample rate comparisonCPT 57421 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.
Vagina And Cervix Biopsy, An Exam Of The Vagina And Cervix Using A Scope (Colposcopy). The Procedure Removes A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Female Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AG - Primary physician UA |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57421 |
| Medicaid Fee Schedule | View Medicaid rates for 57421 |
National average reimbursement for CPT 57421 by major payers:
$206.10
$219.28
$237.40
$205.93
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CPT 57421
5 of 25 sample ratesHigher to lower in this preview
Silicon Valley Surgery Center, Lp
Silicon Valley Surgery Center, L.P.
$3,435.00Published rateSt Augustine Endoscopy Center LLC
$967.00Published rateMt Pleasant Surgery Center LLC
$676.00Published rateHeart Health Center, LLC
Heart Health Center LLC
$525.00Published rateEmpire Surgery Center
$251.00Published rate
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See a sample payer proposalCPT 57421 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57421 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 57421 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 |
|---|---|---|
| 57410-CPT | Low | Exam Pelvis Under Anesthesia |
| 57420-CPT | Low | Colposcopy Of The Entire Vagina, With Cervix If Present |
| 57421-CPT | Moderate | Vagina And Cervix Biopsy, An Exam Of The Vagina And Cervix Using A Scope (Colposcopy). The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
| 57454-CPT | Low | Scope Exam For Cervix Biopsy, An Exam Of The Cervix Using A Scope (Colposcopy). The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57421. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57421 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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