CPT code 56420: Abscess drainage, bartholin gland2026 Medicare rate & RVUs

Drainage of a Bartholin gland abscess, typically performed for a painful, localized vulvar collection at the gland’s duct opening.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.2K Medicare services in 2024

Medicare pays $182.03 for 56420 nationally in the office and $100.20 in a hospital or facility. Local office rates run $160.20–$239.71.

Medicare rate · 56420

Abscess drainage, bartholin gland

Office or facility?

Work RVUs
1.4
Total RVUs
5.45
Global days
010

National rate · 2026

$182.03

Office setting, before claim adjustments.

See every locality for 56420 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 56420 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 56420 covers

CPT 56420 describes opening and draining an abscess involving a Bartholin gland, commonly presenting as a tender, one-sided swelling near the vaginal opening. A gynecologist or another physician may perform the procedure in an office, clinic, or facility setting. The service addresses an abscess; a noninfected Bartholin cyst or an abscess elsewhere on the vulva calls for a different procedural choice.

Report the code when the documented procedure drains a Bartholin gland abscess. The note should identify the gland or site and describe the abscess and drainage performed. The procedure has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are 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.

Where 56420 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$160.20 to $239.71

$160.20$199.95$239.71
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

56420 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$162.65$91.05
Alaska$210.09$122.94
Arizona$176.94$97.64
Arkansas$160.20$89.91
Atlanta, GA$185.82$102.68
Austin, TX$188.60$102.02
Bakersfield, CA$192.01$102.32
Baltimore area, MD$193.97$106.17
Beaumont, TX$170.01$95.55
Brazoria, TX$179.50$98.40

56420 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.

$160.20

$215.52

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
56420 office rate range by state
State / territoryOffice rate rangeLocalities
AK$210.091
AL$162.651
AR$160.201
AZ$176.941
CA$191.33–$239.7129
CO$188.981
CT$194.451
DC$208.121
DE$179.931
FL$180.47–$199.513
GA$169.83–$185.822
GU$196.091
HI$196.091
IA$166.381
ID$167.631
IL$175.48–$193.384
IN$168.621
KS$165.841
KY$167.231
LA$167.06–$175.622
MA$187.90–$207.762
MD$183.37–$208.123
ME$168.82–$177.932
MI$172.00–$183.082
MN$180.081
MO$164.26–$175.943
MS$162.251
MT$182.021
NC$170.611
ND$177.271
NE$167.251
NH$186.251
NJ$196.39–$205.892
NM$173.081
NV$180.821
NY$173.29–$215.955
OH$171.031
OK$166.631
OR$179.15–$194.862
PA$171.16–$189.642
PR$183.311
RI$186.261
SC$171.161
SD$176.711
TN$166.741
TX$170.01–$188.608
UT$173.581
VA$177.51–$208.122
VI$183.311
VT$176.801
WA$187.47–$211.792
WI$171.141
WV$168.821
WY$179.951

How the 56420 rate is calculated

Each of 56420’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 · 56420

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.40

1.40 RVUs× 1.000 GPCI

Practice expense3.81

3.81 RVUs× 1.000 GPCI

Malpractice0.24

0.24 RVUs× 1.000 GPCI

Adjusted RVUs

5.4500

Conversion factor

$33.4009

Medicare rate

$182.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 56420

56420 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 56420

Abscess drainage, bartholin gland

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 56420

Abscess drainage, bartholin gland

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

56420 without 51 · national office

$182.03

Abscess drainage, bartholin gland

56420-51 · Second procedure: 50%

$91.02

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%).

When to use modifier 51

56420 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 56420

    Abscess drainage, bartholin gland1.4 wRVU

    $182.03

  • 56405

    Abscess drainage, vulva or perineum1.45 wRVU

    $145.96−$36.07

  • 56440

    Cyst marsupialization, bartholin gland2.82 wRVU

    Not priced

  • 56740

    Bartholin excision, gland or cyst removal4.76 wRVU

    Not priced

How to choose

56405Abscess drainageVulva or perineum
Choose 56420 when the abscess involves the Bartholin gland; choose 56405 for a vulvar or perineal abscess at another site.
56440Cyst marsupializationBartholin gland
56420 reports drainage of a Bartholin gland abscess. 56440 reports marsupialization of a Bartholin gland cyst.
56740Bartholin excisionGland or cyst removal
56420 is drainage of an abscess; 56740 is excision of the Bartholin gland.

56420 billing questions

How do I distinguish 56420 from 56405?

Use 56420 for an abscess of the Bartholin gland. Code 56405 is for incision and drainage of a vulvar or perineal abscess not identified as a Bartholin gland abscess.

How does 56420 differ from 56440?

56420 is for draining a Bartholin gland abscess. 56440 describes marsupialization of a Bartholin gland cyst, a different procedure.

Should modifier 50 be appended for bilateral disease?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.

Are related postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.

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
RVUs for 56420PPRRVU2026_Oct_nonQPP.csv, line 6,404 (RVU26D)

Open CMS sourceHow we calculate rates

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