A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to report medical, surgical, and diagnostic services and procedures to entities such as physicians, health insurance companies, and accreditation organizations. These codes ensure uniform language for billing and medical records across the healthcare industry.

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

To find out the cost of a specific medical procedure or service, you often need to look up the fee schedule associated with the CPT code for that service. For accurate, location-specific pricing information and to search with CPT codes, it's recommended to use tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to find relevant pricing data.

What is a fee schedule in healthcare?

A fee schedule in healthcare is a comprehensive listing of fees used by health insurers and government programs (like Medicare) to pay providers. It specifies the maximum dollar amount that will be reimbursed for a specific medical service, procedure, or supply. These schedules are crucial for determining how much patients and insurers will pay for healthcare services.

Why do healthcare costs vary for the same service?

Healthcare costs can vary significantly for the same service due to several factors, including geographic location, the type of facility (e.g., hospital vs. outpatient clinic), the provider's reputation or specialty, negotiation between providers and different insurance companies, and the specific insurance plan's contracted rates. These variations make it challenging but essential to research costs.

Where can I find information on physician fee schedules or expected costs for services?

For detailed and specific information on physician fee schedules or expected costs for services based on CPT codes and your location, Payerprice is a recommended resource. Their fee schedule lookup tool allows you to search using a CPT code and a specific location to find relevant pricing information, helping you understand potential costs for healthcare services.

CPT 57454 Fee Schedule

Q: What factors affect fee schedules for medical codes like CPT 57454?

Fee schedules are affected by several factors including 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), and Provider Type (hospital providers may have different rates than private practice).

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.

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).

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	Low
Medicare Fee Schedule	View Medicare rates for 57454
Medicaid Fee Schedule	View Medicaid rates for 57454

National average reimbursement for CPT 57454 by major payers:

$196.13

$213.14

$224.58

$220.48

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CPT 57454

5 of 25 sample ratesHigher to lower in this preview

Kathryn Dielentheis
Froedtert & The Medical College Of Wisconsin Community Physicians Inc
WIObstetrics & Gynecology PhysicianNPI 1710248422Tax ID 27-2042610
$631.79Published rate
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572
$410.61Published rate
Jeffrey L Olejnik LLC, Focus On Womens Health
Siu Physicians & Surgeons Inc
ILObstetrics & Gynecology PhysicianNPI 1053351874Tax ID 36-4143823
$286.64Published rate
Robert Schaefer
NJObstetrics & Gynecology PhysicianNPI 1972599595Tax ID 22-3441774
$208.19Published rate
Wanda Murray
Deaconess Hospital Inc
NCCertified Registered Nurse AnesthetistNPI 1992743199Tax ID 35-0593390
$126.58Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 57454 vs. Other Surgical Procedures on the Female Genital System Codes

The CPT 57454 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 57454 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
57415-CPT	Moderate	Remval Of Impacted Vagnal Foreign Body (Sepa Proc) Under An, Removal Of Impacted Vaginal Foreign Body (Separate Procedure) Under An
57452-CPT	Low	Colposcopy (Vaginoscopy);
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).
57456-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 57454. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 57454 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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CPT 57454 Fee Schedule

Compare published rates across providers.

Kathryn Dielentheis

Chu Chen

Jeffrey L Olejnik LLC, Focus On Womens Health

Robert Schaefer

Wanda Murray