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

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

CMS RVU26DEffective Oct 1, 2026One payment locality1.2K Medicare services in 2024

In Delaware, Medicare pays $179.93 for 56420 in the office and $99.08 when it’s performed in a hospital or facility.

$179.93Office (non-facility)
$99.08Hospital or facility
−1.2%vs the national office rate ($182.03)

Check a contract rate as a % of Medicare · 56420 nationwide

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

We’ll open 56420 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 56420 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Delaware compares for 56420

Across 109 of 109 payment localities, the office rate for 56420 runs from $160.20 in Arkansas to $239.71 in San Benito County, CA. Delaware pays $179.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

56420 in Delaware vs other payment areas
  1. Delaware · this page$179.93
  2. Los Angeles, CA · California$204.55+$24.62
  3. Washington, DC area · District of Columbia$208.12+$28.19
  4. Miami, FL · Florida$199.51+$19.58
  5. Chicago, IL · Illinois$193.38+$13.45
  6. Manhattan, NY · New York$210.34+$30.41
  7. Alaska · Alaska$210.09+$30.16

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

56420 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$162.65$91.05
ArkansasArkansas$160.20$89.91
ArizonaArizona$176.94$97.64
Bakersfield, CACalifornia$192.01$102.32
Chico, CACalifornia$191.33$101.64
El Centro, CACalifornia$191.37$101.68
Fresno, CACalifornia$191.33$101.64
Hanford, CACalifornia$191.33$101.64

56420 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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

See 56420 in every payment locality

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.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,404

Code
56420
Physician work
1.40
Practice expense
3.81
Malpractice
0.24

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 56420 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0051.4070
Practice expense3.81× 0.9883.7643
Malpractice0.24× 0.8990.2158
Total RVUs5.3870
Conversion factor× 33.4009

Office rate, Delaware$179.93

Office: (1.4 × 1.005 + 3.81 × 0.988 + 0.24 × 0.899) × $33.4009 = $179.93

Facility: (1.4 × 1.005 + 1.36 × 0.988 + 0.24 × 0.899) × $33.4009 = $99.08

Open 56420 in the RVU calculator

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

Codes related to 56420

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 56420
CodeHow it relatesOffice range, Delaware
Used instead
56405Abscess drainage, vulva or perineumUse for drainage of a vulvar or perineal abscess not identified as a Bartholin gland abscess.$144.26
56440Cyst marsupialization, bartholin glandMarsupialization of a Bartholin gland cyst is a different procedure from abscess drainage.No office rate
56740Bartholin excision, gland or cyst removalExcision of a Bartholin gland is a more extensive procedure than drainage.No office rate

How 56420 has changed in Delaware

56420 · Office / nonfacility

$179.93

Effective 2026-10-01

The base rate is $2.03 higher than on 2025-10-01, moving from $177.90 to $179.93 (1.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $177.90changed to$179.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.44 changed to 1.40
    • Practice expense RVU 3.85 changed to 3.81
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $186.38changed to$177.90

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.95 changed to 3.85

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $183.34changed to$186.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $191.54changed to$183.34

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.94 changed to 3.95
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $197.80changed to$191.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.95 changed to 3.94
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $183.75changed to$197.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.51 changed to 3.95

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $163.95changed to$183.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.78 changed to 3.51
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.78changed to$163.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.24 changed to 2.78
    • Malpractice RVU 0.18 changed to 0.25
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $127.32changed to$141.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.85 changed to 2.24

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $126.26changed to$127.32

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.82 changed to 1.85
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $126.34changed to$126.26

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $127.56changed to$126.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.83 changed to 1.82
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $126.92changed to$127.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $126.37changed to$126.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.80 changed to 1.83
    • Malpractice RVU 0.23 changed to 0.19
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $126.11changed to$126.37

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.00 changed to 1.80
    • Malpractice RVU 0.24 changed to 0.23
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $126.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$179.93$99.08RVU26D
2026-07-01$179.93$99.08RVU26C
2026-04-01$179.93$99.08RVU26B
2026-01-01$179.93$99.08RVU26A
2025-10-01$177.90$106.99RVU25D
2025-07-01$177.90$106.99RVU25C
2025-04-01$177.90$106.99RVU25B
2025-01-01$177.90$106.99RVU25A
2024-10-01$186.38$111.09RVU24D
2024-07-01$186.38$111.09RVU24C
2024-04-01$186.38$111.09RVU24B
2024-03-09$186.38$111.09RVU24AR
2024-01-01$183.34$109.28RVU24A
2023-10-01$191.54$113.73RVU23D
2023-07-01$191.54$113.73RVU23C
2023-04-01$191.54$113.73RVU23B
2023-01-01$191.54$113.73RVU23A
2022-10-01$197.80$116.10RVU22D
2022-07-01$197.80$116.10RVU22C
2022-04-01$197.80$116.10RVU22B
2022-01-01$197.80$116.10RVU22A
2021-10-01$183.75$112.79RVU21D
2021-07-01$183.75$112.79RVU21C
2021-04-01$183.75$112.79RVU21B
2021-01-01$183.75$112.79RVU21A
2020-10-01$163.95$108.68RVU20D
2020-07-01$163.95$108.68RVU20C
2020-04-01$163.95$108.68RVU20B
2020-01-01$163.95$108.68RVU20A
2019-10-01$141.78$101.02RVU19D
2019-07-01$141.78$101.02RVU19C
2019-04-01$141.78$101.02RVU19B
2019-01-01$141.78$101.02RVU19A
2018-10-01$127.32$94.67RVU18D
2018-07-01$127.32$94.67RVU18C
2018-04-01$127.32$94.67RVU18B
2018-01-01$127.32$94.67RVU18AR1
2017-10-01$126.26$95.36RVU17D
2017-07-01$126.26$95.36RVU17C
2017-04-01$126.26$95.36RVU17B
2017-01-01$126.26$95.36RVU17A
2016-10-01$126.34$94.96RVU16D
2016-07-01$126.34$94.96RVU16C
2016-04-01$126.34$94.96RVU16B
2016-01-01$126.34$94.96RVU16A
2015-10-01$127.56$95.70RVU15D
2015-07-01$127.56$95.70RVU15C
2015-04-01$126.92$95.22RVU15B
2015-01-01$126.92$95.22RVU15A
2014-10-01$126.37$95.51RVU14D
2014-07-01$126.37$95.51RVU14C
2014-04-01$126.37$95.51RVU14B
2014-01-01$126.37$95.51RVU14A
2013-10-01$126.11$93.07RVU13D
2013-07-01$126.11$93.07RVU13C
2013-04-01$126.11$93.07RVU13B
2013-01-01$126.11$93.07RVU13AR

Price 56420 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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