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CPT code 56606: Vulvar biopsy, each additional lesion2026 Medicare rate & RVUs in Washington, DC area

Reports biopsy sampling of each additional vulvar or perineal lesion after the primary lesion biopsy, such as when several distinct lesions require tissue diagnosis.

CMS RVU26DEffective Oct 1, 2026One payment locality5K Medicare services in 2024

In Washington, DC area, Medicare pays $43.60 for 56606 in the office and $27.47 when it’s performed in a hospital or facility.

$43.60Office (non-facility)
$27.47Hospital or facility
+11.6%vs the national office rate ($39.08)

Check a contract rate as a % of Medicare · 56606 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 56606 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 56606 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 56606 covers

This add-on represents tissue sampling from an additional, distinct lesion of the vulva or perineum after the primary lesion has been biopsied. A gynecologist or another clinician performing vulvar evaluation may obtain the specimen in an office, procedure room, or operating room. The tissue is typically submitted for histopathologic examination to investigate findings such as a persistent lesion or an area of abnormal vulvar tissue.

Report 56606 with the primary biopsy code 56605, not by itself, when a separate additional lesion is sampled. The record should identify the lesions and support that more than one distinct site was biopsied; repeated sampling of the same lesion is not an additional lesion. CMS classifies 56606 as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period. The code does not represent a vulvectomy or removal of a larger area of vulvar tissue.

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 56606

Across 109 of 109 payment localities, the office rate for 56606 runs from $35.08 in Arkansas to $47.92 in Alaska. Washington, DC area pays $43.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

56606 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$43.60
  2. Los Angeles, CA · California$42.11−$1.49
  3. Miami, FL · Florida$44.41+$0.81
  4. Chicago, IL · Illinois$43.19−$0.41
  5. Manhattan, NY · New York$44.92+$1.32
  6. Alaska · Alaska$47.92+$4.32
  7. Alabama · Alabama$35.52−$8.08

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

Every other payment area

56606 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$35.08$23.31
ArizonaArizona$38.09$24.82
Bakersfield, CACalifornia$39.98$24.97
Chico, CACalifornia$39.72$24.71
El Centro, CACalifornia$39.74$24.73
Fresno, CACalifornia$39.72$24.71
Hanford, CACalifornia$39.72$24.71
Madera, CACalifornia$39.72$24.71

56606 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.

$35.08

$47.92

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

View every state and territory as a table
56606 office rate range by state
State / territoryOffice rate rangeLocalities
AK$47.921
AL$35.521
AR$35.081
AZ$38.091
CA$39.72–$47.6429
CO$39.791
CT$41.461
DC$43.601
DE$38.651
FL$39.80–$44.413
GA$37.71–$40.032
GU$40.281
HI$40.281
IA$35.731
ID$36.051
IL$39.20–$43.194
IN$36.221
KS$35.861
KY$36.821
LA$36.88–$38.422
MA$39.71–$42.992
MD$39.23–$43.603
ME$36.50–$37.812
MI$37.90–$40.512
MN$37.491
MO$36.51–$38.223
MS$35.791
MT$39.071
NC$36.791
ND$37.291
NE$35.821
NH$39.441
NJ$41.75–$43.312
NM$38.191
NV$38.601
NY$37.28–$46.225
OH$37.531
OK$36.481
OR$38.11–$40.602
PA$37.43–$40.722
PR$39.231
RI$39.691
SC$37.261
SD$37.081
TN$36.051
TX$37.24–$40.238
UT$37.691
VA$37.89–$43.602
VI$39.231
VT$37.411
WA$39.55–$43.532
WI$36.241
WV$38.011
WY$38.301

See 56606 in every payment locality

How the 56606 rate is calculated

Each of 56606’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 · 56606

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.54

0.54 RVUs× 1.000 GPCI

Practice expense0.54

0.54 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

1.1700

Conversion factor

$33.4009

Medicare rate

$39.08

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

6,411

Code
56606
Physician work
0.54
Practice expense
0.54
Malpractice
0.09

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 56606 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.54× 1.0540.5692
Practice expense0.54× 1.1780.6361
Malpractice0.09× 1.1130.1002
Total RVUs1.3055
Conversion factor× 33.4009

Office rate, Washington, DC area$43.60

Office: (0.54 × 1.054 + 0.54 × 1.178 + 0.09 × 1.113) × $33.4009 = $43.60

Facility: (0.54 × 1.054 + 0.13 × 1.178 + 0.09 × 1.113) × $33.4009 = $27.47

Open 56606 in the RVU calculator

Payment rules and modifiers for 56606

The CMS indicators that decide how 56606 is paid alongside other services.

CMS payment indicators · 56606

Vulvar biopsy, each additional lesion

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

Codes related to 56606

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

Codes related to 56606
CodeHow it relatesOffice range, Washington, DC area
Primary code
56605Vulvar biopsy, first lesion sampledPrimary vulvar or perineal lesion biopsy that must accompany this additional-lesion code.$105.33
Often billed with
88305Tissue pathology exam, level IV specimenMay represent histopathologic examination of submitted biopsy tissue.$79.56
Used instead
11104Punch biopsy, single skin lesionPunch biopsy code for a skin lesion outside the vulva or perineum.$139.28

How 56606 has changed in Washington, DC area

56606 · Office / nonfacility

$43.60

Effective 2026-10-01

The base rate is $2.49 higher than on 2025-10-01, moving from $41.11 to $43.60 (6.1%).

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

    $41.11changed to$43.60

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.55 changed to 0.54
    • Practice expense RVU 0.50 changed to 0.54
    • Malpractice RVU 0.08 changed to 0.09
    • 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

    $42.69changed to$41.11

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $41.99changed to$42.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $44.83changed to$41.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.51 changed to 0.50
    • Malpractice RVU 0.10 changed to 0.09
    • 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

    $45.48changed to$44.83

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.50 changed to 0.51
    • Malpractice RVU 0.09 changed to 0.10
    • 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

    $45.86changed to$45.48

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $45.68changed to$45.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.47 changed to 0.50
    • 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

    $44.33changed to$45.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.46 changed to 0.47
    • Malpractice RVU 0.08 changed to 0.09
    • 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

    $43.84changed to$44.33

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.45 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $43.80changed to$43.84

    • Conversion factor 35.8887 changed to 35.9996
    • 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

    $43.35changed to$43.80

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.44 changed to 0.45
    • 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

    $43.48changed to$43.35

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.45 changed to 0.44
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $43.26changed to$43.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $43.09changed to$43.26

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.44 changed to 0.45
    • Malpractice RVU 0.08 changed to 0.07
    • 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

    $42.27changed to$43.09

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.48 changed to 0.44
    • 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: $42.27

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$43.60$27.47RVU26D
2026-07-01$43.60$27.47RVU26C
2026-04-01$43.60$27.47RVU26B
2026-01-01$43.60$27.47RVU26A
2025-10-01$41.11$30.70RVU25D
2025-07-01$41.11$30.70RVU25C
2025-04-01$41.11$30.70RVU25B
2025-01-01$41.11$30.70RVU25A
2024-10-01$42.69$31.98RVU24D
2024-07-01$42.69$31.98RVU24C
2024-04-01$42.69$31.98RVU24B
2024-03-09$42.69$31.98RVU24AR
2024-01-01$41.99$31.46RVU24A
2023-10-01$44.83$33.32RVU23D
2023-07-01$44.83$33.32RVU23C
2023-04-01$44.83$33.32RVU23B
2023-01-01$44.83$33.32RVU23A
2022-10-01$45.48$33.50RVU22D
2022-07-01$45.48$33.50RVU22C
2022-04-01$45.48$33.50RVU22B
2022-01-01$45.48$33.50RVU22A
2021-10-01$45.86$33.78RVU21D
2021-07-01$45.86$33.78RVU21C
2021-04-01$45.86$33.78RVU21B
2021-01-01$45.86$33.78RVU21A
2020-10-01$45.68$34.66RVU20D
2020-07-01$45.68$34.66RVU20C
2020-04-01$45.68$34.66RVU20B
2020-01-01$45.68$34.66RVU20A
2019-10-01$44.33$33.90RVU19D
2019-07-01$44.33$33.90RVU19C
2019-04-01$44.33$33.90RVU19B
2019-01-01$44.33$33.90RVU19A
2018-10-01$43.84$33.87RVU18D
2018-07-01$43.84$33.87RVU18C
2018-04-01$43.84$33.87RVU18B
2018-01-01$43.84$33.87RVU18AR1
2017-10-01$43.80$34.28RVU17D
2017-07-01$43.80$34.28RVU17C
2017-04-01$43.80$34.28RVU17B
2017-01-01$43.80$34.28RVU17A
2016-10-01$43.35$33.85RVU16D
2016-07-01$43.35$33.85RVU16C
2016-04-01$43.35$33.85RVU16B
2016-01-01$43.35$33.85RVU16A
2015-10-01$43.48$33.52RVU15D
2015-07-01$43.48$33.52RVU15C
2015-04-01$43.26$33.35RVU15B
2015-01-01$43.26$33.35RVU15A
2014-10-01$43.09$33.61RVU14D
2014-07-01$43.09$33.61RVU14C
2014-04-01$43.09$33.61RVU14B
2014-01-01$43.09$33.61RVU14A
2013-10-01$42.27$32.49RVU13D
2013-07-01$42.27$32.49RVU13C
2013-04-01$42.27$32.49RVU13B
2013-01-01$42.27$32.49RVU13AR

Price 56606 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

56606 billing questions

When should 56606 be used instead of 56605?

Use 56605 for the primary lesion biopsy. Use 56606 for each additional distinct vulvar or perineal lesion biopsied during the service.

Can 56606 be reported by itself?

No. It is an add-on code and must be reported with the primary biopsy procedure, 56605.

What documentation supports an additional lesion?

Document the distinct lesion sites or describe how the sampled areas differ, along with the biopsy performed at each site.

How should units be determined?

Count additional distinct lesions biopsied beyond the primary lesion. Do not count multiple samples from one lesion as additional lesions.

Is a pathology examination included in 56606?

56606 describes the biopsy procedure. Histopathology of submitted tissue is a separate service when performed and reportable by the responsible pathology provider.

Does the add-on code have its own global period?

CMS pays 56606 within the primary procedure's global period; report it only with that primary procedure.

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 56606PPRRVU2026_Oct_nonQPP.csv, line 6,411 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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