CPT code 56700: Hymenal surgery, partial excision or ring revision2026 Medicare rate & RVUs in New Jersey
Reports partial removal of hymenal tissue or revision of a restrictive hymenal ring, such as when the tissue causes symptoms or limits vaginal opening.
CMS doesn’t publish an office rate for 56700 in New Jersey.
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 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 in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | Unavailable | $200.32 |
| Rest of New Jersey | Unavailable | $193.69 |
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.
How the rate is built · 56700
RVUs × geographic indexes × conversion factor
Work2.77
2.77 RVUs× 1.000 GPCI
Practice expense2.19
2.19 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
5.4400
Conversion factor
$33.4009
Medicare rate
$181.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 56700
56700 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56700
Hymenal surgery, partial excision or ring revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 56700
Hymenal surgery, partial excision or ring revision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
56700 without 51 · national facility
$181.70
Hymenal surgery, partial excision or ring revision
56700-51 · Second procedure: 50%
$90.85
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%).
56700 compared with similar codes
Compare codes · National
4 codes, side by side
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.
56700 billing questions
How does this differ from a simple hymenotomy?
Use 56700 for partial removal of hymenal tissue or revision of the hymenal ring. A simple incision of hymenal tissue is represented by 56442.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this service and anatomy.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports the code?
Document the hymenal tissue treated, the symptoms or clinical reason for surgery, and whether the work was partial excision or revision rather than a simple incision.
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
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