FeeBase
Log inGet started
Menu

CPT code 56821: Vulvar colposcopy, with biopsy2026 Medicare rate & RVUs in Suburban Chicago, IL

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 Suburban Chicago, IL, Medicare pays $183.75 for 56821 in the office and $112.06 when it’s performed in a hospital or facility.

$183.75Office (non-facility)
$112.06Hospital or facility
+7.4%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 Suburban Chicago, IL
  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 Suburban Chicago, IL 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. Suburban Chicago, IL pays $183.75. The RVUs are the same everywhere; the geographic indexes change the dollars.

56821 in Suburban Chicago, IL vs other payment areas
  1. Suburban Chicago, IL · this page$183.75
  2. Chicago, IL · Illinois$188.37+$4.62
  3. East St. Louis, IL · Illinois$176.56−$7.19
  4. Rest of Illinois · Illinois$170.20−$13.55
  5. Los Angeles, CA · California$186.23+$2.48
  6. Washington, DC area · District of Columbia$192.34+$8.59
  7. Miami, FL · Florida$194.17+$10.42

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

Every other payment area

56821 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$197.55$116.43
AlaskaAlaska$204.66$130.32
AlabamaAlabama$154.06$92.98
ArkansasArkansas$151.95$91.99
ArizonaArizona$166.35$98.70
Bakersfield, CACalifornia$176.10$99.60
Chico, CACalifornia$175.04$98.54
El Centro, CACalifornia$175.11$98.60

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 Suburban Chicago, IL 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

50

Locality
Suburban Chicago, IL
Physician work
1.007
Practice expense
1.027
Malpractice
1.772
Office calculation for 56821 in Suburban Chicago, IL
ComponentRVULocality factorAdjusted
Physician work2.00× 1.0072.0140
Practice expense2.74× 1.0272.8140
Malpractice0.38× 1.7720.6734
Total RVUs5.5013
Conversion factor× 33.4009

Office rate, Suburban Chicago, IL$183.75

Office: (2 × 1.007 + 2.74 × 1.027 + 0.38 × 1.772) × $33.4009 = $183.75

Facility: (2 × 1.007 + 0.65 × 1.027 + 0.38 × 1.772) × $33.4009 = $112.06

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, Suburban Chicago, IL
Same family
56820Vulvar colposcopy, without biopsyVulvar colposcopy without biopsy; distinguishes examination-only service from 56821.$137.12
Used instead
56605Vulvar biopsy, first lesion sampledVulvar or perineal biopsy when the service is biopsy without vulvar colposcopy.$100.06
57455Cervical biopsy, colposcopy-guided biopsyColposcopic biopsy service for the cervix rather than the vulva.$173.00

How 56821 has changed in Suburban Chicago, IL

56821 · Office / nonfacility

$183.75

Effective 2026-10-01

The base rate is $9.87 higher than on 2025-10-01, moving from $173.88 to $183.75 (5.7%).

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

    $173.88changed to$183.75

    • 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
    • Practice expense GPCI 1.048 changed to 1.027
    • Malpractice GPCI 1.556 changed to 1.772

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $180.34changed to$173.88

    • 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

    $177.39changed to$180.34

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $182.84changed to$177.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.65 changed to 2.68
    • Practice expense GPCI 1.055 changed to 1.048
    • Malpractice GPCI 1.530 changed to 1.556

  5. January 1, 2023

    RVU23A

    $185.35changed to$182.84

    • 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 1.006 changed to 1.007
    • Practice expense GPCI 1.062 changed to 1.055
    • Malpractice GPCI 1.504 changed to 1.530

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $181.02changed to$185.35

    • 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

    $176.23changed to$181.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.20 changed to 2.49
    • Work GPCI 1.008 changed to 1.006
    • Practice expense GPCI 1.057 changed to 1.062
    • Malpractice GPCI 1.535 changed to 1.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $167.74changed to$176.23

    • 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 1.009 changed to 1.008
    • Practice expense GPCI 1.053 changed to 1.057
    • Malpractice GPCI 1.565 changed to 1.535

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $161.31changed to$167.74

    • 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

    $162.04changed to$161.31

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.055 changed to 1.053
    • Malpractice GPCI 1.601 changed to 1.565

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $161.87changed to$162.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.85 changed to 1.86
    • Work GPCI 1.012 changed to 1.011
    • Practice expense GPCI 1.057 changed to 1.055
    • Malpractice GPCI 1.636 changed to 1.601

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $163.04changed to$161.87

    • 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

    $162.23changed to$163.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $164.78changed to$162.23

    • 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 1.019 changed to 1.012
    • Practice expense GPCI 1.065 changed to 1.057
    • Malpractice GPCI 1.671 changed to 1.636

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $164.54changed to$164.78

    • 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 1.025 changed to 1.019
    • Practice expense GPCI 1.072 changed to 1.065
    • Malpractice GPCI 1.706 changed to 1.671

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$164.54

  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$183.75$112.06RVU26D
2026-07-01$183.75$112.06RVU26C
2026-04-01$183.75$112.06RVU26B
2026-01-01$183.75$112.06RVU26A
2025-10-01$173.88$118.63RVU25D
2025-07-01$173.88$118.63RVU25C
2025-04-01$173.88$118.63RVU25B
2025-01-01$173.88$118.63RVU25A
2024-10-01$180.34$121.73RVU24D
2024-07-01$180.34$121.73RVU24C
2024-04-01$180.34$121.73RVU24B
2024-03-09$180.34$121.73RVU24AR
2024-01-01$177.39$119.74RVU24A
2023-10-01$182.84$123.14RVU23D
2023-07-01$182.84$123.14RVU23C
2023-04-01$182.84$123.14RVU23B
2023-01-01$182.84$123.14RVU23A
2022-10-01$185.35$124.35RVU22D
2022-07-01$185.35$124.35RVU22C
2022-04-01$185.35$124.35RVU22B
2022-01-01$185.35$124.35RVU22A
2021-10-01$181.02$123.96RVU21D
2021-07-01$181.02$123.96RVU21C
2021-04-01$181.02$123.96RVU21B
2021-01-01$181.02$123.96RVU21A
2020-10-01$176.23$127.78RVU20D
2020-07-01$176.23$127.78RVU20C
2020-04-01$176.23$127.78RVU20B
2020-01-01$176.23$127.78RVU20A
2019-10-01$167.74$126.76RVU19D
2019-07-01$167.74$126.76RVU19C
2019-04-01$167.74$126.76RVU19B
2019-01-01$167.74$126.76RVU19A
2018-10-01$161.31$126.81RVU18D
2018-07-01$161.31$126.81RVU18C
2018-04-01$161.31$126.81RVU18B
2018-01-01$161.31$126.81RVU18AR1
2017-10-01$162.04$128.35RVU17D
2017-07-01$162.04$128.35RVU17C
2017-04-01$162.04$128.35RVU17B
2017-01-01$162.04$128.35RVU17A
2016-10-01$161.87$127.81RVU16D
2016-07-01$161.87$127.81RVU16C
2016-04-01$161.87$127.81RVU16B
2016-01-01$161.87$127.81RVU16A
2015-10-01$163.04$128.85RVU15D
2015-07-01$163.04$128.85RVU15C
2015-04-01$162.23$128.21RVU15B
2015-01-01$162.23$128.21RVU15A
2014-10-01$164.78$131.21RVU14D
2014-07-01$164.78$131.21RVU14C
2014-04-01$164.78$131.21RVU14B
2014-01-01$164.78$131.21RVU14A
2013-10-01$164.54$128.79RVU13D
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 Suburban Chicago, IL rate applies

Suburban Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 178 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

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 Suburban Chicago, ILGPCI2026.csv, line 50 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 56821 pays in Suburban Chicago, IL?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 56821 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist