CPT code 56633: Vulvectomy, radical, complete2026 Medicare rate & RVUs in California
Reported for radical removal of the entire vulva, typically to treat vulvar cancer when the operation does not include inguinofemoral lymphadenectomy.
CMS doesn’t publish an office rate for 56633 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 56633 covers
A radical complete vulvectomy removes the entire vulva along with deeper tissue as required for the surgical margins. Gynecologic oncologists typically perform it in an operating room for extensive vulvar disease, including cancer requiring a more radical excision than a simple vulvectomy. This code represents the vulvar operation without inguinofemoral lymphadenectomy; codes in the same family identify procedures that include lymph node dissection.
Choose this code when the operative report supports both complete removal and radical depth, rather than a partial or simple vulvectomy. Document the extent of vulvar excision and whether inguinofemoral nodes were removed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare may pay an assistant at surgery and permits co-surgeons; team surgery is 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 56633 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,143.77 |
| Chico, CA | Unavailable | $1,132.27 |
| El Centro, CA | Unavailable | $1,132.97 |
| Fresno, CA | Unavailable | $1,132.27 |
| Hanford, CA | Unavailable | $1,132.27 |
| Los Angeles, CA | Unavailable | $1,197.87 |
| Madera, CA | Unavailable | $1,132.27 |
| Marin County, CA | Unavailable | $1,288.07 |
| Merced, CA | Unavailable | $1,132.27 |
| Modesto, CA | Unavailable | $1,132.27 |
| Napa, CA | Unavailable | $1,240.28 |
| Oxnard, CA | Unavailable | $1,183.45 |
| Redding, CA | Unavailable | $1,132.27 |
| Rest of California | Unavailable | $1,132.27 |
| Riverside, CA | Unavailable | $1,177.28 |
| Sacramento, CA | Unavailable | $1,169.32 |
| Salinas, CA | Unavailable | $1,164.64 |
| San Benito County, CA | Unavailable | $1,320.32 |
| San Diego, CA | Unavailable | $1,178.60 |
| San Francisco, CA | Unavailable | $1,283.31 |
| San Luis Obispo, CA | Unavailable | $1,148.26 |
| Santa Clara County, CA | Unavailable | $1,300.87 |
| Santa Cruz, CA | Unavailable | $1,179.07 |
| Santa Maria, CA | Unavailable | $1,165.33 |
| Santa Rosa, CA | Unavailable | $1,189.65 |
| Stockton, CA | Unavailable | $1,132.27 |
| Vallejo, CA | Unavailable | $1,233.42 |
| Visalia, CA | Unavailable | $1,132.27 |
| Yuba City, CA | Unavailable | $1,132.27 |
How the 56633 rate is calculated
Each of 56633’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 · 56633
RVUs × geographic indexes × conversion factor
Work19.13
19.13 RVUs× 1.000 GPCI
Practice expense11.13
11.13 RVUs× 1.000 GPCI
Malpractice4.19
4.19 RVUs× 1.000 GPCI
Adjusted RVUs
34.4500
Conversion factor
$33.4009
Medicare rate
$1,150.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 56633
56633 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56633
Vulvectomy, radical, complete
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 56633
Vulvectomy, radical, complete
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
56633 without 51 · national facility
$1,150.66
Vulvectomy, radical, complete
56633-51 · Second procedure: 50%
$575.33
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%).
56633 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 56625VulvectomyComplete, simple excision
- 56625 represents complete but simple vulvar removal. Choose 56633 when the documentation supports radical excision and deeper margins.
- 56630VulvectomyPartial, without lymphadenectomy
- 56630 is a radical partial vulvectomy. Choose 56633 when the radical excision encompasses the entire vulva.
- 56634Radical vulvectomyComplete, unilateral node dissection
- 56634 includes unilateral inguinofemoral lymphadenectomy with radical complete vulvectomy; 56633 represents the vulvar operation without that node dissection.
- 56637Radical vulvectomyComplete, bilateral nodes
- 56637 includes bilateral inguinofemoral lymphadenectomy with radical complete vulvectomy; 56633 does not include the node dissection.
56633 billing questions
How does this differ from a simple complete vulvectomy?
This code represents complete removal with radical depth and margins. A simple complete vulvectomy is selected when the operation is complete but does not involve radical excision.
Can this code be reported when inguinofemoral nodes are removed?
Use the corresponding code for a radical complete vulvectomy that includes unilateral or bilateral inguinofemoral lymphadenectomy. Code 56633 represents the vulvar excision without that node dissection.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code; the operation is not reported with modifier 50.
What documentation supports complete radical excision?
The operative report should establish that the entire vulva was removed and describe the radical depth and extent of excision. It should also clarify whether inguinofemoral lymphadenectomy was performed.
How does the 90-day global affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical global package.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons for this procedure. Team-surgery reporting is 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
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