What is a CPT code and why is it important for understanding medical costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. It's crucial for understanding medical costs because insurers use these codes to process claims and determine reimbursement rates, and patients can use them to research the cost of specific procedures.

How can I find out the cost of a specific medical procedure or service before I receive it?

To find out the cost of a specific medical procedure or service, you typically need to know the CPT code associated with it. Once you have the CPT code, you can use a fee schedule lookup tool. For a reliable and specific search based on your situation, you can use Payerprice's fee schedule lookup tool, which allows you to search using a CPT code and your specific location to get detailed pricing information.

What is a "fee schedule" in healthcare, and why would I need to look it up?

A fee schedule is a comprehensive listing of the fees that a healthcare provider or insurer has established for specific medical services and procedures, identified by CPT codes. You would need to look it up to understand the expected cost of a service, compare prices, or estimate your out-of-pocket expenses before receiving care.

Where can I find the fee schedule for a particular CPT code in my area?

For a specific fee schedule based on a CPT code and your location, Payerprice offers a dedicated fee schedule lookup tool. This tool allows users to search by CPT code and specific geographic location to find relevant pricing information, helping you understand potential costs for medical services based on your specific situation.

Why do medical costs for the same procedure vary so much between different providers or locations?

Medical costs can vary significantly due to several factors, including the specific healthcare provider's negotiated rates with insurance companies, geographic location (cost of living, facility overhead), the type of facility (hospital vs. outpatient clinic), and the complexity of the service. For specific pricing relevant to your situation, you can use tools like Payerprice to research costs based on CPT code and location.

CPT 57425 Fee Schedule

Last Verified: August 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 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.

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 AS - PA/NP/CNS assistant at surgery 80 - Assistant surgeon
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 57425

National average reimbursement for CPT 57425 by major payers:

$1,218.82

$1,301.62

$1,359.07

$1,575.42

Preview provider-level rates for...

For billing codeCPT 57425

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	57425	$3200.00	1114984523 - AUGUSTA UROLOGY SURGICENTER, LLC	582360326 - (GA) AUGUSTA UROLOGY SURGICENTER, LLC	GA	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$4520.00	1245239656 - SURGERY CENTER OF GILBERT LLC, SURGERY CENTER OF GILBERT	731596190 - (AZ) SURGERY CENTER OF GILBERT, LLC	AZ	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$4339.00	1710177795 - ASPEN SURGERY CENTER, LLC, ASPEN SURGERY CENTER	205090169 - (CA) ASPEN SURGERY CENTER LLC	CA	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$6450.00	1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC	200064962	NJ	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$7773.00	1104006006 - PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC	205755383 - (CA) PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC	CA	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$3753.00	1306989249 - MEDICAL ARTS SURGERY CENTER LLC	208261564	TX	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$6365.00	1851950281 - YUMA ADVANCED SURGICAL SUITES LLC	833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC	AZ	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$6259.00	1841858024 - VANGUARD ASC, LLC, VANGUARD SURGICAL CENTER	352661529	NJ	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$3399.00	1205875283 - RWJ ENDOSURGICAL CENTER LLC	900872940 - (NJ) RWJ ENDOSURGICAL CENTER LLC	NJ	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$3635.00	1477108900 - CLEARWAY SURGERY CENTER OF CRESTVIEW, LLC	842479344 - (FL) CLEARWAY SURGERY CENTER OF CRESTVIEW LLC	FL	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$3117.00	1619970472 - CYPRESS OUTPATIENT SURGICAL CENTER, INC.	770173551 - (CA) CYPRESS OUTPATIENT SURGICAL CENTER, INC.	CA	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$2700.00	1386999662 - PALOS HILLS SURGERY CENTER, LLC	451617538 - (IL) PALOS HILLS SURGERY CENTER LLC	IL	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$918.00	1619967726 - JOHN P LYDON DPM, BETHESDA AMBULATORY SURGICAL CENTER	521248448 - (MD) JOHN P LYDON, DPM	MD	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$7229.00	1336649565 - ADVANCED SURGICAL CARE OF ST. LOUIS, LLC	823086965 - (MO) ADVANCED SURGICAL CARE OF ST LOUIS LLC	MO	Ambulatory Surgical Clinic/Center (261QA1903X)
United	57425	$4410.00	1922365808 - GWINNETT ADVANCED SURGERY CENTER, LLC	455067682	GA	Ambulatory Surgical Clinic/Center (261QA1903X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 57425 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57425 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 57425 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
57283-CPT	Moderate	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.
57295-CPT	Moderate	Rvision (Inclu Remval) Of Prosthet Vagnal Grft; Vagnal Appr, Revision (Including Removal) Of Prosthetic Vaginal Graft; Vaginal Appr
57308-CPT	Moderate	Genital Repair Surgery, Surgery To Close An Abnormal Opening Between The Vagina And Rectum. The Procedure May Include A Temporary Bypass For The Rectum (Colostomy) Or Reconstruction Of The Perineum.
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 57425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57425 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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