CPT code 56820: Vulvar colposcopy, without biopsy2026 Medicare rate & RVUs in Queens, NY

A clinician examines vulvar tissue under magnification to assess visible abnormalities when a diagnostic colposcopic evaluation is needed and no biopsy is taken.

CMS RVU26DEffective Oct 1, 2026One payment locality6.3K Medicare services in 2024

In Queens, NY, Medicare pays $147.80 for 56820 in the office and $85.81 when it’s performed in a hospital or facility.

$147.80Office (non-facility)
$85.81Hospital or facility
+15.5%vs the national office rate ($127.93)

Check a contract rate as a % of Medicare · 56820 nationwide

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

We’ll open 56820 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 56820 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 56820 covers

This service is a focused, magnified examination of the vulvar skin and mucosa, typically performed by a gynecologist or another qualified clinician in an office or outpatient setting. It may be used to assess a visible lesion, persistent color or texture change, or another finding that warrants closer evaluation. The examination helps characterize the affected area; tissue sampling is not part of this code.

Report it when the documented service is vulvar colposcopy without biopsy. The record should identify the clinical reason for the examination, the area examined, and the findings; if a biopsy is performed as part of the colposcopic service, use the biopsy-inclusive sibling code 56821 instead. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. 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% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery reporting are 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.

How Queens, NY compares for 56820

Across 109 of 109 payment localities, the office rate for 56820 runs from $113.66 in Arkansas to $160.11 in San Benito County, CA. Queens, NY pays $147.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

56820 in Queens, NY vs other payment areas
  1. Queens, NY · this page$147.80
  2. Manhattan, NY · New York$147.69−$0.11
  3. NYC suburbs and Long Island, NY · New York$152.03+$4.23
  4. Rest of New York · New York$121.74−$26.06
  5. Los Angeles, CA · California$139.73−$8.07
  6. Washington, DC area · District of Columbia$144.06−$3.74

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

56820 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$144.59$90.00
Chicago, ILIllinois$140.30$87.59
AlaskaAlaska$152.82$96.97
AlabamaAlabama$115.24$69.36
ArkansasArkansas$113.66$68.62
ArizonaArizona$124.45$73.64
Bakersfield, CACalifornia$132.06$74.59
Chico, CACalifornia$131.30$73.83

56820 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$113.66

$152.82

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
56820 office rate range by state
State / territoryOffice rate rangeLocalities
AK$152.821
AL$115.241
AR$113.661
AZ$124.451
CA$131.30–$160.1129
CO$131.021
CT$136.201
DC$144.061
DE$126.421
FL$129.38–$144.593
GA$122.08–$131.012
GU$133.741
HI$133.741
IA$116.531
ID$117.561
IL$126.90–$140.304
IN$118.171
KS$116.721
KY$119.371
LA$119.48–$125.012
MA$130.59–$142.542
MD$128.52–$144.063
ME$118.91–$123.972
MI$122.99–$131.662
MN$123.611
MO$118.01–$124.583
MS$115.821
MT$127.911
NC$119.971
ND$122.571
NE$116.921
NH$129.671
NJ$137.20–$142.832
NM$123.921
NV$126.491
NY$121.74–$152.035
OH$121.901
OK$118.411
OR$124.97–$134.182
PA$121.68–$133.422
PR$128.561
RI$130.191
SC$121.241
SD$121.941
TN$117.371
TX$120.97–$131.228
UT$122.801
VA$124.08–$144.062
VI$128.561
VT$122.771
WA$130.12–$144.642
WI$118.741
WV$122.621
WY$125.581

See 56820 in every payment locality

How the 56820 rate is calculated

Each of 56820’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 · 56820

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.46

1.46 RVUs× 1.000 GPCI

Practice expense2.10

2.10 RVUs× 1.000 GPCI

Malpractice0.27

0.27 RVUs× 1.000 GPCI

Adjusted RVUs

3.8300

Conversion factor

$33.4009

Medicare rate

$127.93

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,426

Code
56820
Physician work
1.46
Practice expense
2.10
Malpractice
0.27

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 56820 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0641.5534
Practice expense2.10× 1.1822.4822
Malpractice0.27× 1.4420.3893
Total RVUs4.4250
Conversion factor× 33.4009

Office rate, Queens, NY$147.80

Office: (1.46 × 1.064 + 2.1 × 1.182 + 0.27 × 1.442) × $33.4009 = $147.80

Facility: (1.46 × 1.064 + 0.53 × 1.182 + 0.27 × 1.442) × $33.4009 = $85.81

Open 56820 in the RVU calculator

Payment rules and modifiers for 56820

The CMS indicators that decide how 56820 is paid alongside other services.

CMS payment indicators · 56820

Vulvar colposcopy, without biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

56820 without 51 · national office

$127.93

Vulvar colposcopy, without biopsy

56820-51 · Second procedure: 50%

$63.97

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%).

When to use modifier 51

How 56820 has changed in Queens, NY

56820 · Office / nonfacility

$147.80

Effective 2026-10-01

The base rate is $6.31 higher than on 2025-10-01, moving from $141.49 to $147.80 (4.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $141.49changed to$147.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 2.03 changed to 2.10
    • Malpractice RVU 0.24 changed to 0.27
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $146.40changed to$141.49

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.05 changed to 2.03

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $144.01changed to$146.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $154.36changed to$144.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.02 changed to 2.05
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $162.41changed to$154.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.99 changed to 2.02
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $157.61changed to$162.41

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.89 changed to 1.99
    • Malpractice RVU 0.23 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $151.81changed to$157.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.69 changed to 1.89
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.82changed to$151.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.54 changed to 1.69
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $138.20changed to$141.82

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.46 changed to 1.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $138.04changed to$138.20

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $137.49changed to$138.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.45 changed to 1.46
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $137.98changed to$137.49

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $137.30changed to$137.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $135.42changed to$137.30

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $131.22changed to$135.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.57 changed to 1.45
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $131.22

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$147.80$85.81RVU26D
2026-07-01$147.80$85.81RVU26C
2026-04-01$147.80$85.81RVU26B
2026-01-01$147.80$85.81RVU26A
2025-10-01$141.49$93.56RVU25D
2025-07-01$141.49$93.56RVU25C
2025-04-01$141.49$93.56RVU25B
2025-01-01$141.49$93.56RVU25A
2024-10-01$146.40$95.88RVU24D
2024-07-01$146.40$95.88RVU24C
2024-04-01$146.40$95.88RVU24B
2024-03-09$146.40$95.88RVU24AR
2024-01-01$144.01$94.32RVU24A
2023-10-01$154.36$103.02RVU23D
2023-07-01$154.36$103.02RVU23C
2023-04-01$154.36$103.02RVU23B
2023-01-01$154.36$103.02RVU23A
2022-10-01$162.41$109.29RVU22D
2022-07-01$162.41$109.29RVU22C
2022-04-01$162.41$109.29RVU22B
2022-01-01$162.41$109.29RVU22A
2021-10-01$157.61$108.33RVU21D
2021-07-01$157.61$108.33RVU21C
2021-04-01$157.61$108.33RVU21B
2021-01-01$157.61$108.33RVU21A
2020-10-01$151.81$109.75RVU20D
2020-07-01$151.81$109.75RVU20C
2020-04-01$151.81$109.75RVU20B
2020-01-01$151.81$109.75RVU20A
2019-10-01$141.82$106.35RVU19D
2019-07-01$141.82$106.35RVU19C
2019-04-01$141.82$106.35RVU19B
2019-01-01$141.82$106.35RVU19A
2018-10-01$138.20$106.67RVU18D
2018-07-01$138.20$106.67RVU18C
2018-04-01$138.20$106.67RVU18B
2018-01-01$138.20$106.67RVU18AR1
2017-10-01$138.04$107.46RVU17D
2017-07-01$138.04$107.46RVU17C
2017-04-01$138.04$107.46RVU17B
2017-01-01$138.04$107.46RVU17A
2016-10-01$137.49$107.01RVU16D
2016-07-01$137.49$107.01RVU16C
2016-04-01$137.49$107.01RVU16B
2016-01-01$137.49$107.01RVU16A
2015-10-01$137.98$107.39RVU15D
2015-07-01$137.98$107.39RVU15C
2015-04-01$137.30$106.86RVU15B
2015-01-01$137.30$106.86RVU15A
2014-10-01$135.42$104.97RVU14D
2014-07-01$135.42$104.97RVU14C
2014-04-01$135.42$104.97RVU14B
2014-01-01$135.42$104.97RVU14A
2013-10-01$131.22$99.91RVU13D
2013-07-01$131.22$99.91RVU13C
2013-04-01$131.22$99.91RVU13B
2013-01-01$131.22$99.91RVU13AR

Price 56820 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

56820 billing questions

When should 56820 be used instead of 56821?

Use 56820 for vulvar colposcopic examination without biopsy. When tissue is sampled during the examination, report 56821, the biopsy-inclusive sibling.

Can a separate vulvar biopsy code be reported with 56820?

56820 describes the colposcopic examination without biopsy. If biopsy is performed during that examination, use 56821 rather than reporting 56820 as the no-biopsy service.

What documentation supports 56820?

Document the reason for examining the vulva, the area evaluated, the colposcopic findings, and whether tissue was sampled.

Does the service have a global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

How does the multiple-procedure rule affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this service. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are 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
RVUs for 56820PPRRVU2026_Oct_nonQPP.csv, line 6,426 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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