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See a sample rate comparisonCPT 57423 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.
Surgery For Fallen Bladder, Surgery Aided By A Scope (Laparoscope) To Repair A Condition Where Weakened Muscles Have Resulted In The Bladder Falling Down Into The Vagina.
| Key Fact | Detail |
|---|---|
| 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 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 57423 |
| Medicaid Fee Schedule | View Medicaid rates for 57423 |
National average reimbursement for CPT 57423 by major payers:
$1,126.88
$1,231.05
$1,257.85
$1,507.65
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CPT 57423
5 of 25 sample ratesHigher to lower in this preview
Texas Health Outpatient Surgery Center Alliance
$8,818.00Published rateHanover Nj Endoscopy Asc LLC, Hanover Endoscopy Center
Hanover Nj Endoscopy Asc LLC
$5,484.00Published rateDigestive Disease & Endoscopy Center, LLC, Digestive Disease & Endoscopy Center, PLLC
Digestive Disease & Endoscopy Center, PLLC
$3,823.00Published rateCastle Hills Outpatient Center, Inc., Surgical Arts Center
Castle Hills Outpatient Center Inc
$2,101.00Published rateGastroenterology Care Inc
$987.00Published rate
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See a sample payer proposalCPT 57423 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57423 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 57423 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 |
|---|---|---|
| 57284-CPT | High | Repair Vagina And Bladder, Surgery To Repair And Strengthen Various Tissues Of The Urethra Vagina And Bladder. The Procedures Involved Restore The Normal Anatomical Relationships And Resolve Problems Such As Urinary Incontinence. |
| 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). |
| 57423-CPT | High | Surgery For Fallen Bladder, Surgery Aided By A Scope (Laparoscope) To Repair A Condition Where Weakened Muscles Have Resulted In The Bladder Falling Down Into The Vagina. |
| 57425-CPT | High | Surgery For Prolapsed Vagina, Surgery To Attach The Vagina With A Patch Graft Or Ligaments To A Bony Structure Within The Pelvis Such As The Tip Of The Sacrum. The Muscles Of A Prolapsed Vagina Can No Longer Hold It In Its Correct Position. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57423. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57423 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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