CPT 57425 Fee Schedule
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.
| 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
$1,610.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 57425 | ||||||
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 | Colpopexy, Vaginal; Intra-Peritoneal Approach (Uterosacral, Levator Myorrhaphy) |
| 57295-CPT | Moderate | Revision Incl Removal Of Prosthetic Vaginal Graft Vaginal Approach |
| 57308-CPT | Moderate | Closure Of Rectovaginal Fistula; Transperineal Approach, With Perineal Body Reconstruction, With Or Without Levator Plication |
| 57425-CPT | High | Laparoscopy, Surgical, Colpopexy (Suspension Of Vaginal Apex) |
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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