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CPT code 56605: Vulvar biopsy, first lesion sampled2026 Medicare rate & RVUs in Washington, DC area

Report this procedure when a clinician samples a single vulvar or perineal lesion for tissue diagnosis rather than removing vulvar tissue definitively.

CMS RVU26DEffective Oct 1, 2026One payment locality26.3K Medicare services in 2024

In Washington, DC area, Medicare pays $105.33 for 56605 in the office and $56.14 when it’s performed in a hospital or facility.

$105.33Office (non-facility)
$56.14Hospital or facility
+12.6%vs the national office rate ($93.52)

Check a contract rate as a % of Medicare · 56605 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 56605 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 56605 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 56605 covers

A clinician takes tissue from one vulvar or perineal lesion for histopathologic evaluation, often using a punch or incisional sample when examination findings or symptoms warrant diagnosis. Gynecologists and other clinicians managing vulvar disease may perform the biopsy in an office procedure room or facility. Common reasons include evaluating a persistent ulcer, an abnormal pigmented area, focal thickening, or a lesion concerning for vulvar intraepithelial neoplasia or malignancy.

Report 56605 for the first lesion sampled and 56606 for each additional separately biopsied lesion. Document the lesion site and number, the clinical reason for sampling, and the biopsy performed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate, even for lesions on both sides. CMS does not pay an assistant at surgery for this service; co-surgeons are permitted, but team surgery is not.

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 Washington, DC area compares for 56605

Across 109 of 109 payment localities, the office rate for 56605 runs from $83.19 in Arkansas to $117.24 in San Benito County, CA. Washington, DC area pays $105.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

56605 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$105.33
  2. Los Angeles, CA · California$102.27−$3.06
  3. Miami, FL · Florida$105.33
  4. Chicago, IL · Illinois$102.25−$3.08
  5. Manhattan, NY · New York$107.86+$2.53
  6. Alaska · Alaska$111.89+$6.56
  7. Alabama · Alabama$84.34−$20.99

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

56605 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$83.19$47.33
ArizonaArizona$91.01$50.56
Bakersfield, CACalifornia$96.66$50.90
Chico, CACalifornia$96.12$50.36
El Centro, CACalifornia$96.16$50.40
Fresno, CACalifornia$96.12$50.36
Hanford, CACalifornia$96.12$50.36
Madera, CACalifornia$96.12$50.36

56605 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.

$83.19

$111.89

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

View every state and territory as a table
56605 office rate range by state
State / territoryOffice rate rangeLocalities
AK$111.891
AL$84.341
AR$83.191
AZ$91.011
CA$96.12–$117.2429
CO$95.851
CT$99.531
DC$105.331
DE$92.441
FL$94.45–$105.333
GA$89.19–$95.732
GU$97.901
HI$97.901
IA$85.321
ID$86.061
IL$92.62–$102.254
IN$86.511
KS$85.441
KY$87.271
LA$87.34–$91.352
MA$95.53–$104.272
MD$93.98–$105.333
ME$87.01–$90.722
MI$89.87–$96.082
MN$90.551
MO$86.26–$91.073
MS$84.721
MT$93.511
NC$87.791
ND$89.751
NE$85.611
NH$94.841
NJ$100.30–$104.442
NM$90.531
NV$92.511
NY$89.07–$110.975
OH$89.101
OK$86.601
OR$91.43–$98.182
PA$88.96–$97.502
PR$93.991
RI$95.211
SC$88.661
SD$89.311
TN$85.901
TX$88.44–$95.858
UT$89.791
VA$90.78–$105.332
VI$93.991
VT$89.871
WA$95.20–$105.822
WI$86.971
WV$89.521
WY$91.871

See 56605 in every payment locality

How the 56605 rate is calculated

Each of 56605’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 · 56605

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.07

1.07 RVUs× 1.000 GPCI

Practice expense1.54

1.54 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

2.8000

Conversion factor

$33.4009

Medicare rate

$93.52

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,410

Code
56605
Physician work
1.07
Practice expense
1.54
Malpractice
0.19

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 56605 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0541.1278
Practice expense1.54× 1.1781.8141
Malpractice0.19× 1.1130.2115
Total RVUs3.1534
Conversion factor× 33.4009

Office rate, Washington, DC area$105.33

Office: (1.07 × 1.054 + 1.54 × 1.178 + 0.19 × 1.113) × $33.4009 = $105.33

Facility: (1.07 × 1.054 + 0.29 × 1.178 + 0.19 × 1.113) × $33.4009 = $56.14

Open 56605 in the RVU calculator

Payment rules and modifiers for 56605

The CMS indicators that decide how 56605 is paid alongside other services.

CMS payment indicators · 56605

Vulvar biopsy, first lesion sampled

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

56605 without 51 · national office

$93.52

Vulvar biopsy, first lesion sampled

56605-51 · Second procedure: 50%

$46.76

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 56605

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

Codes related to 56605
CodeHow it relatesOffice range, Washington, DC area
Add-on codes
56606Vulvar biopsy, each additional lesionAdd-on code for each additional separately biopsied vulvar or perineal lesion.$43.60
Used instead
56821Vulvar colposcopy, with biopsyUsed for vulvar colposcopy with biopsy when that examination and biopsy service are performed.$192.34
56620Vulvectomy, simple, partial excisionDefinitive partial vulvar removal, rather than diagnostic sampling of a lesion.No office rate
56625Vulvectomy, complete, simple excisionDefinitive complete simple vulvar removal, rather than biopsy of an individual lesion.No office rate

How 56605 has changed in Washington, DC area

56605 · Office / nonfacility

$105.33

Effective 2026-10-01

The base rate is $0.39 lower than on 2025-10-01, moving from $105.72 to $105.33 (0.4%).

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

    $105.72changed to$105.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 1.60 changed to 1.54
    • Malpractice RVU 0.17 changed to 0.19
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $110.38changed to$105.72

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.63 changed to 1.60
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $108.58changed to$110.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.93changed to$108.58

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $117.48changed to$113.93

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.62 changed to 1.63
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.66changed to$117.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.53 changed to 1.62
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $108.11changed to$113.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.32 changed to 1.53
    • Malpractice RVU 0.18 changed to 0.16
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $99.47changed to$108.11

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.19 changed to 1.32
    • Malpractice RVU 0.14 changed to 0.18
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $95.02changed to$99.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.09 changed to 1.19

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $95.33changed to$95.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.10 changed to 1.09
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $94.84changed to$95.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.09 changed to 1.10
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $95.64changed to$94.84

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $95.16changed to$95.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.65changed to$95.16

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.17 changed to 0.15
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $94.68changed to$95.65

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.19 changed to 1.09
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $94.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$105.33$56.14RVU26D
2026-07-01$105.33$56.14RVU26C
2026-04-01$105.33$56.14RVU26B
2026-01-01$105.33$56.14RVU26A
2025-10-01$105.72$63.31RVU25D
2025-07-01$105.72$63.31RVU25C
2025-04-01$105.72$63.31RVU25B
2025-01-01$105.72$63.31RVU25A
2024-10-01$110.38$65.14RVU24D
2024-07-01$110.38$65.14RVU24C
2024-04-01$110.38$65.14RVU24B
2024-03-09$110.38$65.14RVU24AR
2024-01-01$108.58$64.08RVU24A
2023-10-01$113.93$67.03RVU23D
2023-07-01$113.93$67.03RVU23C
2023-04-01$113.93$67.03RVU23B
2023-01-01$113.93$67.03RVU23A
2022-10-01$117.48$68.29RVU22D
2022-07-01$117.48$68.29RVU22C
2022-04-01$117.48$68.29RVU22B
2022-01-01$117.48$68.29RVU22A
2021-10-01$113.66$68.38RVU21D
2021-07-01$113.66$68.38RVU21C
2021-04-01$113.66$68.38RVU21B
2021-01-01$113.66$68.38RVU21A
2020-10-01$108.11$70.65RVU20D
2020-07-01$108.11$70.65RVU20C
2020-04-01$108.11$70.65RVU20B
2020-01-01$108.11$70.65RVU20A
2019-10-01$99.47$68.20RVU19D
2019-07-01$99.47$68.20RVU19C
2019-04-01$99.47$68.20RVU19B
2019-01-01$99.47$68.20RVU19A
2018-10-01$95.02$68.56RVU18D
2018-07-01$95.02$68.56RVU18C
2018-04-01$95.02$68.56RVU18B
2018-01-01$95.02$68.56RVU18AR1
2017-10-01$95.33$68.95RVU17D
2017-07-01$95.33$68.95RVU17C
2017-04-01$95.33$68.95RVU17B
2017-01-01$95.33$68.95RVU17A
2016-10-01$94.84$68.52RVU16D
2016-07-01$94.84$68.52RVU16C
2016-04-01$94.84$68.52RVU16B
2016-01-01$94.84$68.52RVU16A
2015-10-01$95.64$69.23RVU15D
2015-07-01$95.64$69.23RVU15C
2015-04-01$95.16$68.88RVU15B
2015-01-01$95.16$68.88RVU15A
2014-10-01$95.65$69.38RVU14D
2014-07-01$95.65$69.38RVU14C
2014-04-01$95.65$69.38RVU14B
2014-01-01$95.65$69.38RVU14A
2013-10-01$94.68$67.37RVU13D
2013-07-01$94.68$67.37RVU13C
2013-04-01$94.68$67.37RVU13B
2013-01-01$94.68$67.37RVU13AR

Price 56605 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

56605 billing questions

When should 56606 be reported instead?

Use 56605 for the first lesion biopsied. Report 56606 for each additional, separately sampled lesion.

Can modifier 50 be used for lesions on both sides?

No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

Is the pathology examination included?

The code covers obtaining the biopsy tissue. Histologic examination is a separate laboratory service when performed and reported by the responsible laboratory.

What documentation supports the code?

Record the vulvar or perineal site, the number of lesions sampled, the clinical reason for biopsy, and the procedure performed.

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, with the other procedures subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in the 0-day global period.

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 56605PPRRVU2026_Oct_nonQPP.csv, line 6,410 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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