CPT 57556 Fee Schedule
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.
| 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 • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 57556 |
National average reimbursement for CPT 57556 by major payers:
$735.53
$770.51
$762.85
$966.20
| 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 57556 | ||||||
United | 57556 | $900.00 | 1326215468 - ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | 261470972 - (MI) ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $4781.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $5354.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $2895.00 | 1881620466 - MIDLANDS ORTHOPAEDICS SURGERY CENTER, LLC | 203345412 - (SC) MIDLANDS ORTHOPAEDICS SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $6506.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $5732.00 | 1669111274 - KENOSHA SURGICENTER LLC | 854072921 - (WI) KENOSHA SURGICENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $3792.00 | 1366041469 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $1618.00 | 1114491073 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $749.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $7309.00 | 1093708315 - ASSOCIATED HEALTH SERVICES, INC., JAMES E DAVIS AMBULATORY SURGICAL CENTER | 561845329 - (NC) ASSOCIATED HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $2100.00 | 1003553645 - CYPRESS AMBULATORY SURGERY CENTER, LLC, CURRENCY CIRCLE SURGERY CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $5433.00 | 1235395385 - TENN SM LLC | 680569923 - (TN) TENN SM LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $3119.00 | 1780791798 - LINDSAY HOUSE SURGERY CENTER LLC | 320178342 - (NY) LINDSAY HOUSE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $300.00 | 1730355595 - FORT MYERS ENDOSCOPY CENTER LLC | 800149158 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 57556 | $6506.00 | 1225579295 - SANTA BARBARA OUTPATIENT SURGERY CENTERS LLC, SANTA BARBARA SURGERY CENTER | 371846158 | CA | 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 57556 vs. Other Surgical Procedures on the Female Genital System Codes
The CPT 57556 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 57556 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 |
|---|---|---|
| 57454-CPT | Low | Colposcopy Of The Cervix Including Upper/Adjacent Vagina; With Biopsy(S) Of The Cervix And Endocervical Curettage (Desc Rev 01/01/03) |
| 57522-CPT | Moderate | Conization Of Cervix, With Or Without Fulguration, With Or Without Dilation And Curettage, With Or Without Repair; Loop Electrode Excision |
| 57545-CPT | High | Exc.Cerv.Stump,Abd App;Pelv.Flr Rep |
| 57556-CPT | Moderate | Exc Cervical Stump W Rep Enterocele |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 57556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 57556 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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