CPT code 56634: Radical vulvectomy, complete, unilateral node dissection2026 Medicare rate & RVUs in Maine
Reports complete radical removal of the vulva with lymphadenectomy on one side, typically for extensive vulvar malignancy requiring regional nodal surgery.
CMS doesn’t publish an office rate for 56634 in Maine.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 56634 covers
This operation removes the vulva by a radical approach and includes inguinofemoral lymphadenectomy on one side. It is generally performed in an operating room by a gynecologic oncologist or other surgeon treating vulvar cancer when the planned resection is complete and regional node surgery is indicated. The code distinguishes this service from complete radical vulvectomy without node dissection and from the bilateral node-dissection version.
Select the code from the operative plan and report: documentation should establish complete radical vulvar resection and which inguinofemoral side was dissected. The lymphadenectomy is included in this service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the unilateral service as described; modifier 50 is inappropriate. CMS permits payment for an assistant at surgery and co-surgeons, but not team surgery.
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 56634 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | Unavailable | $1,137.95 |
| Southern Maine, ME | Unavailable | $1,167.78 |
How the 56634 rate is calculated
Each of 56634’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 · 56634
RVUs × geographic indexes × conversion factor
Work20.14
20.14 RVUs× 1.000 GPCI
Practice expense11.99
11.99 RVUs× 1.000 GPCI
Malpractice4.66
4.66 RVUs× 1.000 GPCI
Adjusted RVUs
36.7900
Conversion factor
$33.4009
Medicare rate
$1,228.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 56634
56634 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56634
Radical vulvectomy, complete, unilateral node dissection
| 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 · 56634
Radical vulvectomy, complete, unilateral node dissection
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
56634 without 51 · national facility
$1,228.82
Radical vulvectomy, complete, unilateral node dissection
56634-51 · Second procedure: 50%
$614.41
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%).
56634 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 56633VulvectomyRadical, complete
- Use 56633 for complete radical vulvectomy without inguinofemoral lymphadenectomy. The unilateral node dissection is the distinguishing service in 56634.
- 56637Radical vulvectomyComplete, bilateral nodes
- Use 56637 when the complete radical vulvectomy includes bilateral inguinofemoral lymphadenectomy; 56634 specifies unilateral dissection.
- 56631Radical vulvectomyUnilateral inguinofemoral nodes
- Both include unilateral inguinofemoral lymphadenectomy, but 56631 is for radical partial vulvectomy rather than complete radical vulvectomy.
- 56640Radical vulvectomyComplete with pelvic dissection
- This code includes pelvic lymphadenectomy with radical vulvectomy. Code 56634 describes unilateral inguinofemoral lymphadenectomy without that pelvic nodal component.
56634 billing questions
Should modifier 50 be used when both sides are dissected?
No. This code specifies unilateral lymphadenectomy, and modifier 50 is inappropriate. Use the code for complete radical vulvectomy with bilateral lymphadenectomy when both sides are dissected.
Can the inguinofemoral lymphadenectomy be billed separately?
The unilateral lymphadenectomy is included in this service. Do not separately report that same nodal dissection as an independent procedure.
What documentation supports choosing this code?
The operative report should support a complete radical vulvar resection and identify the unilateral inguinofemoral lymphadenectomy. Document the side and the procedures actually performed.
How does the 90-day global period affect postoperative visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the surgical package.
May an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and for co-surgeons for this code. Team surgery 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
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 56634 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist