CPT code 56441: Labial adhesion lysis, labial adhesions2026 Medicare rate & RVUs

Medicare pays $182.37 for 56441 nationally in the office and $140.62 in a hospital or facility. Local office rates run $162.03–$230.84.

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

What 56441 covers

This service involves separating adhesions that join the labia, typically the labia minora. It is often performed for a child with symptomatic fusion, such as urine trapping, spraying, or local discomfort. A pediatric or general gynecologist, or another qualified clinician, may perform the procedure in an office or procedure setting; the technique and need for anesthesia depend on the patient and extent of the adhesion.

Report 56441 when the clinician actually performs lysis, not merely evaluates the adhesions or recommends conservative treatment. The note should identify the adhesion, clinical indication, and procedure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 56441 pays more and less

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

109 of 109 payment localities

56441 rates by state

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

How the 56441 rate is calculated

Each of 56441’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.

Payment rules and modifiers for 56441

56441 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

56441 compared with similar codes

How to choose

56442HymenotomyHymenal opening incision

56441 separates labial adhesions; 56442 is for a procedure involving the hymen. Identify the tissue being treated.

56405Abscess drainageVulva or perineum

56441 treats fused labial tissue. 56405 is for incision and drainage of a vulvar or perineal abscess.

56420Abscess drainageBartholin gland

56441 is lysis of labial adhesions; 56420 is incision and drainage of a Bartholin gland abscess.

56440Cyst marsupializationBartholin gland

56441 separates labial adhesions. 56440 addresses a Bartholin gland cyst with marsupialization, a different condition and procedure.

Codes related to 56441

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

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

Open CMS sourceHow we calculate rates