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

Reports procedural separation of fused labial tissue, commonly for symptomatic labial adhesions when a clinician performs lysis in an office or procedure setting.

CMS RVU26DEffective Oct 1, 2026One payment locality653 Medicare services in 2024

In New Mexico, Medicare pays $175.92 for 56441 in the office and $137.63 when it’s performed in a hospital or facility.

$175.92Office (non-facility)
$137.63Hospital or facility
−3.5%vs the national office rate ($182.37)

Check a contract rate as a % of Medicare · 56441 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 56441 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 56441 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 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.

How New Mexico compares for 56441

Across 109 of 109 payment localities, the office rate for 56441 runs from $162.03 in Arkansas to $230.84 in San Benito County, CA. New Mexico pays $175.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

56441 in New Mexico vs other payment areas
  1. New Mexico · this page$175.92
  2. Los Angeles, CA · California$200.50+$24.58
  3. Washington, DC area · District of Columbia$205.93+$30.01
  4. Miami, FL · Florida$204.05+$28.13
  5. Chicago, IL · Illinois$198.06+$22.14
  6. Manhattan, NY · New York$210.28+$34.36
  7. Alaska · Alaska$217.01+$41.09

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

Every other payment area

56441 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$164.29$127.76
ArkansasArkansas$162.03$126.16
ArizonaArizona$177.47$137.02
Bakersfield, CACalifornia$189.28$143.52
Chico, CACalifornia$188.32$142.56
El Centro, CACalifornia$188.38$142.62
Fresno, CACalifornia$188.32$142.56
Hanford, CACalifornia$188.32$142.56

56441 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.

$162.03

$217.01

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

View every state and territory as a table
56441 office rate range by state
State / territoryOffice rate rangeLocalities
AK$217.011
AL$164.291
AR$162.031
AZ$177.471
CA$188.32–$230.8429
CO$187.411
CT$194.171
DC$205.931
DE$180.291
FL$183.45–$204.053
GA$173.19–$186.532
GU$192.001
HI$192.001
IA$166.581
ID$167.971
IL$179.61–$198.064
IN$168.851
KS$166.641
KY$169.731
LA$169.79–$177.712
MA$186.69–$204.232
MD$183.36–$205.933
ME$169.66–$177.232
MI$174.68–$186.482
MN$177.431
MO$167.55–$177.343
MS$164.781
MT$182.351
NC$171.221
ND$175.621
NE$167.201
NH$185.261
NJ$195.78–$204.122
NM$175.921
NV$180.581
NY$173.74–$216.205
OH$173.311
OK$168.581
OR$178.58–$192.192
PA$173.12–$190.062
PR$183.361
RI$185.861
SC$172.671
SD$174.831
TN$167.541
TX$172.09–$187.318
UT$174.901
VA$177.24–$205.932
VI$183.361
VT$175.711
WA$186.09–$207.462
WI$170.091
WV$173.481
WY$179.421

See 56441 in every payment locality

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.

How the rate is built · 56441

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.97

1.97 RVUs× 1.000 GPCI

Practice expense3.15

3.15 RVUs× 1.000 GPCI

Malpractice0.34

0.34 RVUs× 1.000 GPCI

Adjusted RVUs

5.4600

Conversion factor

$33.4009

Medicare rate

$182.37

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,406

Code
56441
Physician work
1.97
Practice expense
3.15
Malpractice
0.34

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 56441 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.97× 1.0001.9700
Practice expense3.15× 0.9172.8885
Malpractice0.34× 1.2010.4083
Total RVUs5.2669
Conversion factor× 33.4009

Office rate, New Mexico$175.92

Office: (1.97 × 1 + 3.15 × 0.917 + 0.34 × 1.201) × $33.4009 = $175.92

Facility: (1.97 × 1 + 1.9 × 0.917 + 0.34 × 1.201) × $33.4009 = $137.63

Open 56441 in the RVU calculator

Payment rules and modifiers for 56441

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

CMS payment indicators · 56441

Labial adhesion lysis, labial adhesions

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)0Not paid without supporting documentation.
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 · 56441

Labial adhesion lysis, labial adhesions

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

56441 without 51 · national office

$182.37

Labial adhesion lysis, labial adhesions

56441-51 · Second procedure: 50%

$91.19

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 56441

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

Codes related to 56441
CodeHow it relatesOffice range, New Mexico
Often billed with
99202New patient visit, straightforward MDM or 15 minutesA separately identifiable new-patient office evaluation may be reported with modifier 25 when supported.$72.16
99212Office visit, established patient, straightforwardA separately identifiable established-patient office evaluation may be reported with modifier 25 when supported.$57.03
99213Office visit, established patient, low complexityA separately identifiable established-patient office evaluation may be reported with modifier 25 when supported.$91.75

How 56441 has changed in New Mexico

56441 · Office / nonfacility

$175.92

Effective 2026-10-01

The base rate is $6.69 higher than on 2025-10-01, moving from $169.23 to $175.92 (4.0%).

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

    $169.23changed to$175.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.02 changed to 1.97
    • Malpractice RVU 0.30 changed to 0.34
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $177.05changed to$169.23

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.22 changed to 3.15
    • Malpractice RVU 0.32 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $174.16changed to$177.05

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $178.45changed to$174.16

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.21 changed to 3.22
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $181.95changed to$178.45

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $173.98changed to$181.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.92 changed to 3.21
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $164.40changed to$173.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.42 changed to 2.92
    • Malpractice RVU 0.28 changed to 0.30
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $152.41changed to$164.40

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.06 changed to 2.42
    • Malpractice RVU 0.25 changed to 0.28
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $145.16changed to$152.41

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.86 changed to 2.06
    • Malpractice RVU 0.24 changed to 0.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $143.29changed to$145.16

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.83 changed to 1.86
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $142.19changed to$143.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.82 changed to 1.83
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $144.61changed to$142.19

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.84 changed to 1.82
    • Malpractice RVU 0.27 changed to 0.24

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $143.89changed to$144.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $142.38changed to$143.89

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.80 changed to 1.84
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $139.96changed to$142.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.97 changed to 1.80
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $139.96

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$175.92$137.63RVU26D
2026-07-01$175.92$137.63RVU26C
2026-04-01$175.92$137.63RVU26B
2026-01-01$175.92$137.63RVU26A
2025-10-01$169.23$146.03RVU25D
2025-07-01$169.23$146.03RVU25C
2025-04-01$169.23$146.03RVU25B
2025-01-01$169.23$146.03RVU25A
2024-10-01$177.05$151.36RVU24D
2024-07-01$177.05$151.36RVU24C
2024-04-01$177.05$151.36RVU24B
2024-03-09$177.05$151.36RVU24AR
2024-01-01$174.16$148.89RVU24A
2023-10-01$178.45$151.56RVU23D
2023-07-01$178.45$151.56RVU23C
2023-04-01$178.45$151.56RVU23B
2023-01-01$178.45$151.56RVU23A
2022-10-01$181.95$153.11RVU22D
2022-07-01$181.95$153.11RVU22C
2022-04-01$181.95$153.11RVU22B
2022-01-01$181.95$153.11RVU22A
2021-10-01$173.98$150.22RVU21D
2021-07-01$173.98$150.22RVU21C
2021-04-01$173.98$150.22RVU21B
2021-01-01$173.98$150.22RVU21A
2020-10-01$164.40$148.67RVU20D
2020-07-01$164.40$148.67RVU20C
2020-04-01$164.40$148.67RVU20B
2020-01-01$164.40$148.67RVU20A
2019-10-01$152.41$144.44RVU19D
2019-07-01$152.41$144.44RVU19C
2019-04-01$152.41$144.44RVU19B
2019-01-01$152.41$144.44RVU19A
2018-10-01$145.16$139.53RVU18D
2018-07-01$145.16$139.53RVU18C
2018-04-01$145.16$139.53RVU18B
2018-01-01$145.16$139.53RVU18AR1
2017-10-01$143.29$138.67RVU17D
2017-07-01$143.29$138.67RVU17C
2017-04-01$143.29$138.67RVU17B
2017-01-01$143.29$138.67RVU17A
2016-10-01$142.19$137.25RVU16D
2016-07-01$142.19$137.25RVU16C
2016-04-01$142.19$137.25RVU16B
2016-01-01$142.19$137.25RVU16A
2015-10-01$144.61$139.66RVU15D
2015-07-01$144.61$139.66RVU15C
2015-04-01$143.89$138.96RVU15B
2015-01-01$143.89$138.96RVU15A
2014-10-01$142.38$138.10RVU14D
2014-07-01$142.38$138.10RVU14C
2014-04-01$142.38$138.10RVU14B
2014-01-01$142.38$138.10RVU14A
2013-10-01$139.96$134.97RVU13D
2013-07-01$139.96$134.97RVU13C
2013-04-01$139.96$134.97RVU13B
2013-01-01$139.96$134.97RVU13AR

Price 56441 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

56441 billing questions

When should 56441 be selected instead of 56442?

Use 56441 for separating labial adhesions. Code 56442 describes a procedure involving the hymen, not fused labial tissue.

Does the 10-day global period include follow-up visits?

Related postoperative visits during the 10-day global period are included in 56441.

Can modifier 50 be used for adhesions on both sides?

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

How does a same-session procedure affect payment?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.

What documentation supports reporting 56441?

Document the labial adhesion, why procedural separation was indicated, and the lysis performed. An evaluation or treatment recommendation without lysis does not support this procedure code.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 56441PPRRVU2026_Oct_nonQPP.csv, line 6,406 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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