CPT code 56637: Radical vulvectomy, complete, bilateral nodes2026 Medicare rate & RVUs in Texas
Reports complete radical removal of the vulva with lymph node dissection in both groins, typically for vulvar cancer requiring this extent of surgery.
CMS doesn’t publish an office rate for 56637 in Texas.
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 56637 covers
A gynecologic oncologist typically performs this operation in a hospital operating room for vulvar malignancy requiring complete radical excision and bilateral inguinofemoral lymph node dissection. The procedure includes removal of the vulvar tissue and the specified groin node work on both sides; it is more extensive than a complete vulvectomy without lymphadenectomy or a partial radical excision.
Choose the code from the operative extent, not the diagnosis alone. The operative report should establish complete radical vulvar excision and lymph node dissection on both sides. The bilateral work is represented in the code, so modifier 50 is inappropriate. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available, and co-surgeons are permitted; 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 56637 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,438.05 |
| Beaumont, TX | Unavailable | $1,379.41 |
| Brazoria, TX | Unavailable | $1,393.65 |
| Dallas, TX | Unavailable | $1,411.21 |
| Fort Worth, TX | Unavailable | $1,409.24 |
| Galveston, TX | Unavailable | $1,403.49 |
| Houston, TX | Unavailable | $1,505.80 |
| Rest of Texas | Unavailable | $1,391.70 |
How the 56637 rate is calculated
Each of 56637’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 · 56637
RVUs × geographic indexes × conversion factor
Work24.13
24.13 RVUs× 1.000 GPCI
Practice expense13.16
13.16 RVUs× 1.000 GPCI
Malpractice5.59
5.59 RVUs× 1.000 GPCI
Adjusted RVUs
42.8800
Conversion factor
$33.4009
Medicare rate
$1,432.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 56637
56637 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56637
Radical vulvectomy, complete, bilateral nodes
| 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 · 56637
Radical vulvectomy, complete, bilateral nodes
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
56637 without 51 · national facility
$1,432.23
Radical vulvectomy, complete, bilateral nodes
56637-51 · Second procedure: 50%
$716.12
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%).
56637 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 56633VulvectomyRadical, complete
- Use 56633 for complete radical vulvar excision without the bilateral inguinofemoral lymphadenectomy included in 56637.
- 56634Radical vulvectomyComplete, unilateral node dissection
- Use 56634 when the complete radical operation includes unilateral groin node dissection; 56637 represents dissection on both sides.
- 56640Radical vulvectomyComplete with pelvic dissection
- Use 56640 when pelvic lymph nodes are also removed with the complete radical vulvar operation and bilateral groin dissection.
- 56632Radical vulvectomyPartial, bilateral nodes
- Use 56632 for radical partial vulvar excision with bilateral groin node dissection; 56637 represents complete radical excision.
56637 billing questions
How does this differ from code 56634?
This code represents complete radical vulvar excision with lymph node dissection on both sides. Code 56634 describes the corresponding complete radical operation with unilateral inguinofemoral lymphadenectomy.
Should modifier 50 be added?
No. The code already represents bilateral groin node dissection, and CMS identifies modifier 50 as inappropriate for this service.
Are the groin node dissections separately reported?
The bilateral inguinofemoral lymphadenectomy is included in this code. The operative documentation should support node dissection on both sides.
What documentation supports choosing this code?
The operative report should describe complete radical excision of the vulva and lymph node dissection in both groins. A cancer diagnosis by itself does not establish the operative extent.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available, and co-surgeons are permitted. 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
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