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CPT code 56821: Vulvar colposcopy, with biopsy2026 Medicare rate & RVUs in Santa Clara County, CA

Reports magnified examination of vulvar tissue with targeted biopsy when evaluating suspicious lesions or abnormal vulvar findings.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Santa Clara County, CA, Medicare pays $211.16 for 56821 in the office and $110.50 when it’s performed in a hospital or facility.

$211.16Office (non-facility)
$110.50Hospital or facility
+23.5%vs the national office rate ($171.01)

Check a contract rate as a % of Medicare · 56821 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 56821 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Santa Clara County, CA
  2. What 56821 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 56821 covers

Vulvar colposcopy with biopsy uses magnification and directed inspection of the vulvar surface, often after application of acetic acid, to identify abnormal epithelium and obtain tissue. Gynecologists commonly perform it in an office or outpatient setting when lesions or abnormal vulvar findings require histologic evaluation, including concern for vulvar intraepithelial neoplasia. The sampled tissue is sent for pathology; the code represents the examination and biopsy in the same service.

Report 56821 when the colposcopic vulvar examination includes one or more directed biopsies; use 56820 when the examination has no biopsy. Record the indication, vulvar site and appearance, colposcopic findings, biopsy locations, and specimen submission. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others are paid at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgery and team surgery 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 Santa Clara County, CA compares for 56821

Across 109 of 109 payment localities, the office rate for 56821 runs from $151.95 in Arkansas to $212.92 in San Benito County, CA. Santa Clara County, CA pays $211.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

56821 in Santa Clara County, CA vs other payment areas
  1. Santa Clara County, CA · this page$211.16
  2. Bakersfield, CA · California$176.10−$35.06
  3. Chico, CA · California$175.04−$36.12
  4. El Centro, CA · California$175.11−$36.05
  5. Fresno, CA · California$175.04−$36.12
  6. Hanford, CA · California$175.04−$36.12
  7. Los Angeles, CA · California$186.23−$24.93

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

Every other payment area

56821 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$175.04$98.54
Merced, CACalifornia$175.04$98.54
Modesto, CACalifornia$175.04$98.54
Napa, CACalifornia$198.08$106.07
Oxnard, CACalifornia$184.75$102.24
Redding, CACalifornia$175.04$98.54
Rest of CaliforniaCalifornia$175.04$98.54
Riverside, CACalifornia$179.14$102.63

56821 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$151.95

$204.66

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

View every state and territory as a table
56821 office rate range by state
State / territoryOffice rate rangeLocalities
AK$204.661
AL$154.061
AR$151.951
AZ$166.351
CA$175.04–$212.9229
CO$174.891
CT$182.061
DC$192.341
DE$168.971
FL$173.37–$194.173
GA$163.57–$175.232
GU$178.211
HI$178.211
IA$155.581
ID$157.001
IL$170.20–$188.374
IN$157.811
KS$155.931
KY$159.781
LA$159.95–$167.342
MA$174.36–$190.112
MD$171.74–$192.343
ME$158.89–$165.512
MI$164.69–$176.522
MN$164.731
MO$158.05–$166.653
MS$154.981
MT$170.991
NC$160.301
ND$163.471
NE$156.071
NH$173.181
NJ$183.34–$190.732
NM$165.971
NV$168.981
NY$162.67–$203.465
OH$163.151
OK$158.391
OR$166.88–$178.992
PA$162.81–$178.422
PR$171.831
RI$173.931
SC$162.151
SD$162.581
TN$156.811
TX$161.87–$175.688
UT$164.231
VA$165.73–$192.342
VI$171.831
VT$163.831
WA$173.70–$192.802
WI$158.391
WV$164.491
WY$167.711

See 56821 in every payment locality

How the 56821 rate is calculated

Each of 56821’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 · 56821

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.00

2.00 RVUs× 1.000 GPCI

Practice expense2.74

2.74 RVUs× 1.000 GPCI

Malpractice0.38

0.38 RVUs× 1.000 GPCI

Adjusted RVUs

5.1200

Conversion factor

$33.4009

Medicare rate

$171.01

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

The exact Santa Clara County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,427

Code
56821
Physician work
2.00
Practice expense
2.74
Malpractice
0.38

GPCI2026.csv

28

Locality
Santa Clara County, CA
Physician work
1.110
Practice expense
1.442
Malpractice
0.397
Office calculation for 56821 in Santa Clara County, CA
ComponentRVULocality factorAdjusted
Physician work2.00× 1.1102.2200
Practice expense2.74× 1.4423.9511
Malpractice0.38× 0.3970.1509
Total RVUs6.3219
Conversion factor× 33.4009

Office rate, Santa Clara County, CA$211.16

Office: (2 × 1.11 + 2.74 × 1.442 + 0.38 × 0.397) × $33.4009 = $211.16

Facility: (2 × 1.11 + 0.65 × 1.442 + 0.38 × 0.397) × $33.4009 = $110.50

Open 56821 in the RVU calculator

Payment rules and modifiers for 56821

The CMS indicators that decide how 56821 is paid alongside other services.

CMS payment indicators · 56821

Vulvar colposcopy, with 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

56821 without 51 · national office

$171.01

Vulvar colposcopy, with biopsy

56821-51 · Second procedure: 50%

$85.51

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

Codes related to 56821

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

Codes related to 56821
CodeHow it relatesOffice range, Santa Clara County, CA
Same family
56820Vulvar colposcopy, without biopsyVulvar colposcopy without biopsy; distinguishes examination-only service from 56821.$158.85
Used instead
56605Vulvar biopsy, first lesion sampledVulvar or perineal biopsy when the service is biopsy without vulvar colposcopy.$116.36
57455Cervical biopsy, colposcopy-guided biopsyColposcopic biopsy service for the cervix rather than the vulva.$198.07

How 56821 has changed in Santa Clara County, CA

56821 · Office / nonfacility

$211.16

Effective 2026-10-01

The base rate is $10.92 higher than on 2025-10-01, moving from $200.24 to $211.16 (5.5%).

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

    $200.24changed to$211.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.05 changed to 2.00
    • Practice expense RVU 2.64 changed to 2.74
    • Malpractice RVU 0.35 changed to 0.38
    • Work GPCI 1.100 changed to 1.110
    • Practice expense GPCI 1.435 changed to 1.442
    • Malpractice GPCI 0.420 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $207.97changed to$200.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.68 changed to 2.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $204.58changed to$207.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $207.75changed to$204.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.65 changed to 2.68
    • Work GPCI 1.098 changed to 1.100
    • Practice expense GPCI 1.409 changed to 1.435
    • Malpractice GPCI 0.417 changed to 0.420

  5. January 1, 2023

    RVU23A

    $208.02changed to$207.75

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.62 changed to 2.65
    • Malpractice RVU 0.34 changed to 0.35
    • Work GPCI 1.096 changed to 1.098
    • Practice expense GPCI 1.383 changed to 1.409
    • Malpractice GPCI 0.414 changed to 0.417

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $203.18changed to$208.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.49 changed to 2.62
    • Malpractice RVU 0.32 changed to 0.34

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $193.89changed to$203.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.20 changed to 2.49
    • Work GPCI 1.089 changed to 1.096
    • Practice expense GPCI 1.369 changed to 1.383
    • Malpractice GPCI 0.401 changed to 0.414

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $182.29changed to$193.89

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.01 changed to 2.20
    • Malpractice RVU 0.30 changed to 0.32
    • Work GPCI 1.083 changed to 1.089
    • Practice expense GPCI 1.354 changed to 1.369
    • Malpractice GPCI 0.388 changed to 0.401

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $174.64changed to$182.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.86 changed to 2.01
    • Malpractice RVU 0.29 changed to 0.30

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $174.41changed to$174.64

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.086 changed to 1.083
    • Practice expense GPCI 1.351 changed to 1.354
    • Malpractice GPCI 0.402 changed to 0.388

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $173.55changed to$174.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.85 changed to 1.86
    • Work GPCI 1.088 changed to 1.086
    • Practice expense GPCI 1.347 changed to 1.351
    • Malpractice GPCI 0.416 changed to 0.402

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $174.32changed to$173.55

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.31 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $173.46changed to$174.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $173.50changed to$173.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.84 changed to 1.85
    • Malpractice RVU 0.33 changed to 0.31
    • Work GPCI 1.083 changed to 1.088
    • Practice expense GPCI 1.342 changed to 1.347
    • Malpractice GPCI 0.466 changed to 0.416

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $172.52changed to$173.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.01 changed to 1.84
    • Malpractice RVU 0.34 changed to 0.33
    • Work GPCI 1.077 changed to 1.083
    • Practice expense GPCI 1.337 changed to 1.342
    • Malpractice GPCI 0.516 changed to 0.466

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$172.52

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$211.16$110.50RVU26D
2026-07-01$211.16$110.50RVU26C
2026-04-01$211.16$110.50RVU26B
2026-01-01$211.16$110.50RVU26A
2025-10-01$200.24$124.58RVU25D
2025-07-01$200.24$124.58RVU25C
2025-04-01$200.24$124.58RVU25B
2025-01-01$200.24$124.58RVU25A
2024-10-01$207.97$127.72RVU24D
2024-07-01$207.97$127.72RVU24C
2024-04-01$207.97$127.72RVU24B
2024-03-09$207.97$127.72RVU24AR
2024-01-01$204.58$125.64RVU24A
2023-10-01$207.75$128.01RVU23D
2023-07-01$207.75$128.01RVU23C
2023-04-01$207.75$128.01RVU23B
2023-01-01$207.75$128.01RVU23A
2022-10-01$208.02$128.57RVU22D
2022-07-01$208.02$128.57RVU22C
2022-04-01$208.02$128.57RVU22B
2022-01-01$208.02$128.57RVU22A
2021-10-01$203.18$128.86RVU21D
2021-07-01$203.18$128.86RVU21C
2021-04-01$203.18$128.86RVU21B
2021-01-01$203.18$128.86RVU21A
2020-10-01$193.89$131.15RVU20D
2020-07-01$193.89$131.15RVU20C
2020-04-01$193.89$131.15RVU20B
2020-01-01$193.89$131.15RVU20A
2019-10-01$182.29$129.59RVU19D
2019-07-01$182.29$129.59RVU19C
2019-04-01$182.29$129.59RVU19B
2019-01-01$182.29$129.59RVU19A
2018-10-01$174.64$130.28RVU18D
2018-07-01$174.64$130.28RVU18C
2018-04-01$174.64$130.28RVU18B
2018-01-01$174.64$130.28RVU18AR1
2017-10-01$174.41$131.26RVU17D
2017-07-01$174.41$131.26RVU17C
2017-04-01$174.41$131.26RVU17B
2017-01-01$174.41$131.26RVU17A
2016-10-01$173.55$130.14RVU16D
2016-07-01$173.55$130.14RVU16C
2016-04-01$173.55$130.14RVU16B
2016-01-01$173.55$130.14RVU16A
2015-10-01$174.32$130.76RVU15D
2015-07-01$174.32$130.76RVU15C
2015-04-01$173.46$130.11RVU15B
2015-01-01$173.46$130.11RVU15A
2014-10-01$173.50$131.19RVU14D
2014-07-01$173.50$131.19RVU14C
2014-04-01$173.50$131.19RVU14B
2014-01-01$173.50$131.19RVU14A
2013-10-01$172.52$127.94RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 56821 for an earlier date of service

Where the Santa Clara County, CA rate applies

Santa Clara County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • San Jose
  • Santa Clara
  • Sunnyvale
  • Alum Rock
  • Burbank
  • Cambrian Park
  • Campbell
  • Cupertino

Browse all communities in California

56821 billing questions

When should 56821 be chosen over 56820?

Use 56821 when the vulvar colposcopic examination includes a directed biopsy. Use 56820 for the examination without biopsy.

Is the biopsy separately reportable?

The biopsy is included in 56821 when performed as part of the vulvar colposcopic service. Do not separately report a vulvar biopsy code for that same biopsy.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the session are paid at 50% under the standard multiple-procedure reduction.

What documentation supports reporting 56821?

Document the reason for examination, vulvar findings and biopsy site or sites, and that tissue was obtained and submitted for pathology.

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 56821PPRRVU2026_Oct_nonQPP.csv, line 6,427 (RVU26D)
Geographic factors for Santa Clara County, CAGPCI2026.csv, line 28 (RVU26D)

Open CMS sourceHow we calculate rates

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