CPT code 56700: Hymenal surgery, partial excision or ring revision2026 Medicare rate & RVUs

Medicare pays $181.70 for 56700 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 56700 covers

A gynecologist typically performs this procedure to remove part of the hymen or revise a hymenal ring that is restrictive, thickened, or scarred. Patients may have symptoms such as difficulty with tampon insertion or pain related to the hymenal opening. The service is performed in a surgical setting, with the operative work directed at the hymenal tissue rather than a broader repair of the vaginal opening or perineum.

Choose this code when the documented operation involves partial hymenectomy or revision of the hymenal ring; a simple incision of hymenal tissue is a different service. The operative note should identify the tissue treated, the reason for surgery, and the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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 56700 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

56700 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 56700 rate is calculated

Each of 56700’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.

Payment rules and modifiers for 56700

56700 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

56700 compared with similar codes

How to choose

56442HymenotomyHymenal opening incision

This code describes partial hymenectomy or hymenal ring revision. Choose 56442 for a simple incision of hymenal tissue.

56800Introital repairPlastic repair

This code is for repair of the introitus. Choose 56700 when the operative work is confined to partial removal or revision of the hymenal ring.

56810PerineoplastyNonobstetric perineal repair

This code addresses perineal repair. Choose 56700 when the documented procedure treats the hymen or hymenal ring instead.

Codes related to 56700

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

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

Open CMS sourceHow we calculate rates