CPT code 56405: Abscess drainage, vulva or perineum2026 Medicare rate & RVUs in North Dakota
Reports incision and drainage of an abscess in the vulva or perineum, excluding a Bartholin gland abscess coded to its specific procedure.
In North Dakota, Medicare pays $140.80 for 56405 in the office and $111.74 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 56405 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 56405 covers
A clinician incises and drains a localized collection of pus in the vulvar or perineal tissues. The service may be performed by a gynecologist, family physician, or other qualified clinician in an office or facility setting. A vulvar soft-tissue abscess is an example; an abscess of the Bartholin gland has its own code. The documented site should distinguish the treated abscess from a Bartholin gland abscess and from an abscess elsewhere on the skin.
Report 56405 when the abscess is in the vulva or perineum and the service is incision and drainage. The record should identify the anatomic location and describe the drainage procedure. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How North Dakota compares for 56405
Across 109 of 109 payment localities, the office rate for 56405 runs from $129.22 in Arkansas to $186.53 in San Benito County, CA. North Dakota pays $140.80. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$140.80
- Los Angeles, CA · California$161.29+$20.49
- Washington, DC area · District of Columbia$165.37+$24.57
- Miami, FL · Florida$162.88+$22.08
- Chicago, IL · Illinois$157.99+$17.19
- Manhattan, NY · New York$168.54+$27.74
- Alaska · Alaska$172.05+$31.25
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $131.09 | $105.66 |
| ArkansasArkansas | $129.22 | $104.26 |
| ArizonaArizona | $141.96 | $113.80 |
| Bakersfield, CACalifornia | $152.02 | $120.17 |
| Chico, CACalifornia | $151.29 | $119.44 |
| El Centro, CACalifornia | $151.33 | $119.48 |
| Fresno, CACalifornia | $151.29 | $119.44 |
| Hanford, CACalifornia | $151.29 | $119.44 |
| Madera, CACalifornia | $151.29 | $119.44 |
| Merced, CACalifornia | $151.29 | $119.44 |
| Modesto, CACalifornia | $151.29 | $119.44 |
| Napa, CACalifornia | $172.99 | $134.69 |
| Oxnard, CACalifornia | $160.21 | $125.87 |
| Redding, CACalifornia | $151.29 | $119.44 |
| Rest of CaliforniaCalifornia | $151.29 | $119.44 |
| Riverside, CACalifornia | $154.09 | $122.24 |
| Sacramento, CACalifornia | $158.16 | $124.36 |
| Salinas, CACalifornia | $157.56 | $123.88 |
| San Diego, CACalifornia | $160.85 | $126.10 |
| Marin County, CACalifornia | $182.29 | $141.32 |
| San Francisco, CACalifornia | $182.00 | $141.02 |
| San Benito County, CACalifornia | $186.53 | $144.63 |
| Santa Clara County, CACalifornia | $185.32 | $143.42 |
| San Luis Obispo, CACalifornia | $155.11 | $122.01 |
| Santa Cruz, CACalifornia | $162.05 | $126.75 |
| Santa Maria, CACalifornia | $158.04 | $124.15 |
| Santa Rosa, CACalifornia | $163.64 | $127.96 |
| Stockton, CACalifornia | $151.29 | $119.44 |
| Vallejo, CACalifornia | $172.57 | $134.27 |
| Visalia, CACalifornia | $151.29 | $119.44 |
| Yuba City, CACalifornia | $151.29 | $119.44 |
| ColoradoColorado | $150.33 | $119.41 |
| ConnecticutConnecticut | $155.60 | $124.30 |
| DelawareDelaware | $144.26 | $115.55 |
| Fort Lauderdale, FLFlorida | $154.13 | $124.70 |
| Rest of FloridaFlorida | $146.42 | $118.64 |
| Atlanta, GAGeorgia | $149.27 | $119.75 |
| Rest of GeorgiaGeorgia | $138.03 | $112.11 |
| Hawaii, Guam, HIHawaii | $154.48 | $121.44 |
| IowaIowa | $133.17 | $106.58 |
| IdahoIdaho | $134.28 | $107.54 |
| East St. Louis, ILIllinois | $147.66 | $120.93 |
| Rest of IllinoisIllinois | $143.12 | $116.59 |
| Suburban Chicago, ILIllinois | $155.40 | $125.56 |
| IndianaIndiana | $135.01 | $108.07 |
| KansasKansas | $133.13 | $106.86 |
| KentuckyKentucky | $135.36 | $109.53 |
| New Orleans, LALouisiana | $141.90 | $114.56 |
| Rest of LouisianaLouisiana | $135.38 | $109.66 |
| Metropolitan Boston, MAMassachusetts | $164.23 | $129.53 |
| Rest of MassachusettsMassachusetts | $149.68 | $119.08 |
| Baltimore area, MDMaryland | $155.28 | $124.10 |
| Rest of MarylandMaryland | $146.80 | $117.39 |
| Rest of MaineMaine | $135.57 | $108.84 |
| Southern Maine, MEMaine | $141.96 | $113.16 |
| Detroit, MIMichigan | $148.81 | $120.77 |
| Rest of MichiganMichigan | $139.35 | $112.82 |
| MinnesotaMinnesota | $142.42 | $112.52 |
| Metropolitan Kansas City, MOMissouri | $140.34 | $113.06 |
| Metropolitan St. Louis, MOMissouri | $141.71 | $114.05 |
| Rest of MissouriMissouri | $133.48 | $108.43 |
| MississippiMississippi | $131.35 | $106.33 |
| MontanaMontana | $145.94 | $116.89 |
| North CarolinaNorth Carolina | $136.87 | $109.76 |
| NebraskaNebraska | $133.72 | $106.90 |
| New HampshireNew Hampshire | $148.52 | $118.27 |
| Northern New JerseyNew Jersey | $163.82 | $130.11 |
| Rest of New JerseyNew Jersey | $156.92 | $125.18 |
| New MexicoNew Mexico | $140.33 | $113.69 |
| NevadaNevada | $144.60 | $115.51 |
| NYC suburbs and Long Island, NYNew York | $173.30 | $138.75 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $158.41 | $126.59 |
| Queens, NYNew York | $169.07 | $134.72 |
| Rest of New YorkNew York | $138.94 | $111.33 |
| OhioOhio | $138.30 | $111.77 |
| OklahomaOklahoma | $134.52 | $108.57 |
| Portland, OROregon | $154.38 | $122.09 |
| Rest of OregonOregon | $143.03 | $114.08 |
| Metropolitan Philadelphia, PAPennsylvania | $152.15 | $121.90 |
| Rest of PennsylvaniaPennsylvania | $138.20 | $111.52 |
| Puerto RicoPuerto Rico | $146.81 | $117.43 |
| Rhode IslandRhode Island | $148.88 | $118.86 |
| South CarolinaSouth Carolina | $137.91 | $111.06 |
| South DakotaSouth Dakota | $140.20 | $111.14 |
| TennesseeTennessee | $133.86 | $107.44 |
| Austin, TXTexas | $150.22 | $119.48 |
| Beaumont, TXTexas | $137.35 | $110.91 |
| Brazoria, TXTexas | $143.64 | $114.84 |
| Dallas, TXTexas | $144.81 | $115.87 |
| Fort Worth, TXTexas | $144.03 | $115.38 |
| Galveston, TXTexas | $144.23 | $115.38 |
| Houston, TXTexas | $148.99 | $120.14 |
| Rest of TexasTexas | $140.59 | $113.01 |
| UtahUtah | $139.75 | $112.43 |
| VirginiaVirginia | $141.90 | $113.33 |
| Virgin Islands, VIUnited States Virgin Islands | $146.81 | $117.43 |
| VermontVermont | $140.78 | $112.02 |
| Rest of WashingtonWashington | $149.22 | $118.63 |
| King County, WAWashington | $166.96 | $131.31 |
| WisconsinWisconsin | $136.22 | $108.38 |
| West VirginiaWest Virginia | $138.07 | $112.81 |
| WyomingWyoming | $143.70 | $114.65 |
56405 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$129.22
$172.05
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $172.05 | 1 |
| AL | $131.09 | 1 |
| AR | $129.22 | 1 |
| AZ | $141.96 | 1 |
| CA | $151.29–$186.53 | 29 |
| CO | $150.33 | 1 |
| CT | $155.60 | 1 |
| DC | $165.37 | 1 |
| DE | $144.26 | 1 |
| FL | $146.42–$162.88 | 3 |
| GA | $138.03–$149.27 | 2 |
| GU | $154.48 | 1 |
| HI | $154.48 | 1 |
| IA | $133.17 | 1 |
| ID | $134.28 | 1 |
| IL | $143.12–$157.99 | 4 |
| IN | $135.01 | 1 |
| KS | $133.13 | 1 |
| KY | $135.36 | 1 |
| LA | $135.38–$141.90 | 2 |
| MA | $149.68–$164.23 | 2 |
| MD | $146.80–$165.37 | 3 |
| ME | $135.57–$141.96 | 2 |
| MI | $139.35–$148.81 | 2 |
| MN | $142.42 | 1 |
| MO | $133.48–$141.71 | 3 |
| MS | $131.35 | 1 |
| MT | $145.94 | 1 |
| NC | $136.87 | 1 |
| ND | $140.80 | 1 |
| NE | $133.72 | 1 |
| NH | $148.52 | 1 |
| NJ | $156.92–$163.82 | 2 |
| NM | $140.33 | 1 |
| NV | $144.60 | 1 |
| NY | $138.94–$173.30 | 5 |
| OH | $138.30 | 1 |
| OK | $134.52 | 1 |
| OR | $143.03–$154.38 | 2 |
| PA | $138.20–$152.15 | 2 |
| PR | $146.81 | 1 |
| RI | $148.88 | 1 |
| SC | $137.91 | 1 |
| SD | $140.20 | 1 |
| TN | $133.86 | 1 |
| TX | $137.35–$150.22 | 8 |
| UT | $139.75 | 1 |
| VA | $141.90–$165.37 | 2 |
| VI | $146.81 | 1 |
| VT | $140.78 | 1 |
| WA | $149.22–$166.96 | 2 |
| WI | $136.22 | 1 |
| WV | $138.07 | 1 |
| WY | $143.70 | 1 |
How the 56405 rate is calculated
Each of 56405’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 56405
RVUs × geographic indexes × conversion factor
Work1.45
1.45 RVUs× 1.000 GPCI
Practice expense2.66
2.66 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
4.3700
Conversion factor
$33.4009
Medicare rate
$145.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,403
- Code
- 56405
- Physician work
- 1.45
- Practice expense
- 2.66
- Malpractice
- 0.26
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.45 | × 1.000 | 1.4500 |
| Practice expense | 2.66 | × 1.000 | 2.6600 |
| Malpractice | 0.26 | × 0.406 | 0.1056 |
| Total RVUs | 4.2156 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$140.80
Office: (1.45 × 1 + 2.66 × 1 + 0.26 × 0.406) × $33.4009 = $140.80
Facility: (1.45 × 1 + 1.79 × 1 + 0.26 × 0.406) × $33.4009 = $111.74
Payment rules and modifiers for 56405
56405 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56405
Abscess drainage, vulva or perineum
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 56405
Abscess drainage, vulva or perineum
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
56405 without 51 · national office
$145.96
Abscess drainage, vulva or perineum
56405-51 · Second procedure: 50%
$72.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 56405 has changed in North Dakota
56405 · Office / nonfacility
$140.80
Effective 2026-10-01
The base rate is $3.34 higher than on 2025-10-01, moving from $137.46 to $140.80 (2.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$137.46changed to$140.80
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.49 changed to 1.45
- Practice expense RVU 2.62 changed to 2.66
- Malpractice RVU 0.27 changed to 0.26
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$143.78changed to$137.46
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.70 changed to 2.62
- Malpractice RVU 0.25 changed to 0.27
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$141.43changed to$143.78
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$146.68changed to$141.43
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.72 changed to 2.70
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$149.77changed to$146.68
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.73 changed to 2.72
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$140.89changed to$149.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.44 changed to 2.73
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$128.34changed to$140.89
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.94 changed to 2.44
- Malpractice RVU 0.26 changed to 0.25
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$113.98changed to$128.34
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.57 changed to 1.94
- Malpractice RVU 0.19 changed to 0.26
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$108.45changed to$113.98
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.42 changed to 1.57
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$108.52changed to$108.45
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.43 changed to 1.42
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$107.60changed to$108.52
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.41 changed to 1.43
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$108.75changed to$107.60
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.42 changed to 1.41
- Malpractice RVU 0.21 changed to 0.19
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$108.21changed to$108.75
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$108.69changed to$108.21
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.41 changed to 1.42
- Malpractice RVU 0.25 changed to 0.21
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$108.00changed to$108.69
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.55 changed to 1.41
- Malpractice RVU 0.26 changed to 0.25
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $108.00
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $140.80 | $111.74 | RVU26D |
| 2026-07-01 | $140.80 | $111.74 | RVU26C |
| 2026-04-01 | $140.80 | $111.74 | RVU26B |
| 2026-01-01 | $140.80 | $111.74 | RVU26A |
| 2025-10-01 | $137.46 | $120.32 | RVU25D |
| 2025-07-01 | $137.46 | $120.32 | RVU25C |
| 2025-04-01 | $137.46 | $120.32 | RVU25B |
| 2025-01-01 | $137.46 | $120.32 | RVU25A |
| 2024-10-01 | $143.78 | $124.14 | RVU24D |
| 2024-07-01 | $143.78 | $124.14 | RVU24C |
| 2024-04-01 | $143.78 | $124.14 | RVU24B |
| 2024-03-09 | $143.78 | $124.14 | RVU24AR |
| 2024-01-01 | $141.43 | $122.11 | RVU24A |
| 2023-10-01 | $146.68 | $125.33 | RVU23D |
| 2023-07-01 | $146.68 | $125.33 | RVU23C |
| 2023-04-01 | $146.68 | $125.33 | RVU23B |
| 2023-01-01 | $146.68 | $125.33 | RVU23A |
| 2022-10-01 | $149.77 | $126.58 | RVU22D |
| 2022-07-01 | $149.77 | $126.58 | RVU22C |
| 2022-04-01 | $149.77 | $126.58 | RVU22B |
| 2022-01-01 | $149.77 | $126.58 | RVU22A |
| 2021-10-01 | $140.89 | $123.09 | RVU21D |
| 2021-07-01 | $140.89 | $123.09 | RVU21C |
| 2021-04-01 | $140.89 | $123.09 | RVU21B |
| 2021-01-01 | $140.89 | $123.09 | RVU21A |
| 2020-10-01 | $128.34 | $118.95 | RVU20D |
| 2020-07-01 | $128.34 | $118.95 | RVU20C |
| 2020-04-01 | $128.34 | $118.95 | RVU20B |
| 2020-01-01 | $128.34 | $118.95 | RVU20A |
| 2019-10-01 | $113.98 | $112.90 | RVU19D |
| 2019-07-01 | $113.98 | $112.90 | RVU19C |
| 2019-04-01 | $113.98 | $112.90 | RVU19B |
| 2019-01-01 | $113.98 | $112.90 | RVU19A |
| 2018-10-01 | $108.45 | $107.73 | RVU18D |
| 2018-07-01 | $108.45 | $107.73 | RVU18C |
| 2018-04-01 | $108.45 | $107.73 | RVU18B |
| 2018-01-01 | $108.45 | $107.73 | RVU18AR1 |
| 2017-10-01 | $108.52 | $107.81 | RVU17D |
| 2017-07-01 | $108.52 | $107.81 | RVU17C |
| 2017-04-01 | $108.52 | $107.81 | RVU17B |
| 2017-01-01 | $108.52 | $107.81 | RVU17A |
| 2016-10-01 | $107.60 | $106.89 | RVU16D |
| 2016-07-01 | $107.60 | $106.89 | RVU16C |
| 2016-04-01 | $107.60 | $106.89 | RVU16B |
| 2016-01-01 | $107.60 | $106.89 | RVU16A |
| 2015-10-01 | $108.75 | $108.03 | RVU15D |
| 2015-07-01 | $108.75 | $108.03 | RVU15C |
| 2015-04-01 | $108.21 | $107.49 | RVU15B |
| 2015-01-01 | $108.21 | $107.49 | RVU15A |
| 2014-10-01 | $108.69 | $107.97 | RVU14D |
| 2014-07-01 | $108.69 | $107.97 | RVU14C |
| 2014-04-01 | $108.69 | $107.97 | RVU14B |
| 2014-01-01 | $108.69 | $107.97 | RVU14A |
| 2013-10-01 | $108.00 | $107.32 | RVU13D |
| 2013-07-01 | $108.00 | $107.32 | RVU13C |
| 2013-04-01 | $108.00 | $107.32 | RVU13B |
| 2013-01-01 | $108.00 | $107.32 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
56405 billing questions
When should 56405 be used instead of 56420?
Use 56405 for an abscess in vulvar or perineal tissue. Use 56420 when the abscess involves the Bartholin gland.
What documentation supports 56405?
Document the abscess location in the vulva or perineum and the incision-and-drainage service performed. Clarify whether the Bartholin gland is involved.
Can modifier 50 be reported?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are permitted, but team surgery is not.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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