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CPT code 57100: Vaginal biopsy, simple mucosal sampling2026 Medicare rate & RVUs in Chicago, IL

Report this service for a simple biopsy of vaginal mucosa, such as sampling a localized abnormal area for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality4.6K Medicare services in 2024

In Chicago, IL, Medicare pays $115.30 for 57100 in the office and $68.30 when it’s performed in a hospital or facility.

$115.30Office (non-facility)
$68.30Hospital or facility
+9.6%vs the national office rate ($105.21)

Check a contract rate as a % of Medicare · 57100 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 57100 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 57100 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 57100 covers

A clinician, commonly a gynecologist, takes a limited sample of vaginal mucosa for diagnosis, often from a localized area that appears abnormal on examination. The procedure may be performed in an office or a facility. The tissue is submitted for microscopic evaluation; the biopsy service is distinct from the laboratory’s examination of the specimen when that service is performed.

Choose this code for a simple mucosal biopsy, rather than the more extensive biopsy described by 57105 or an excision such as removal of a vaginal cyst or tumor. Document the sampled site, the reason for biopsy, and the work performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons 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 Chicago, IL compares for 57100

Across 109 of 109 payment localities, the office rate for 57100 runs from $93.36 in Arkansas to $132.09 in San Benito County, CA. Chicago, IL pays $115.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

57100 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$115.30
  2. East St. Louis, IL · Illinois$107.96−$7.34
  3. Rest of Illinois · Illinois$104.24−$11.06
  4. Suburban Chicago, IL · Illinois$112.75−$2.55
  5. Los Angeles, CA · California$115.10−$0.20
  6. Washington, DC area · District of Columbia$118.62+$3.32
  7. Miami, FL · Florida$118.86+$3.56

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

Every other payment area

57100 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$121.54$67.21
AlaskaAlaska$125.27$75.47
AlabamaAlabama$94.68$53.76
ArkansasArkansas$93.36$53.19
ArizonaArizona$102.33$57.02
Bakersfield, CACalifornia$108.73$57.48
Chico, CACalifornia$108.11$56.86
El Centro, CACalifornia$108.15$56.90

57100 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.

$93.36

$125.27

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

View every state and territory as a table
57100 office rate range by state
State / territoryOffice rate rangeLocalities
AK$125.271
AL$94.681
AR$93.361
AZ$102.331
CA$108.11–$132.0929
CO$107.831
CT$112.061
DC$118.621
DE$103.961
FL$106.32–$118.863
GA$100.27–$107.752
GU$110.171
HI$110.171
IA$95.791
ID$96.641
IL$104.24–$115.304
IN$97.141
KS$95.921
KY$98.061
LA$98.14–$102.742
MA$107.46–$117.412
MD$105.71–$118.623
ME$97.73–$101.972
MI$101.05–$108.202
MN$101.741
MO$96.91–$102.413
MS$95.121
MT$105.201
NC$98.621
ND$100.851
NE$96.121
NH$106.701
NJ$112.90–$117.582
NM$101.811
NV$104.041
NY$100.09–$125.125
OH$100.161
OK$97.281
OR$102.80–$110.482
PA$99.99–$109.742
PR$105.751
RI$107.101
SC$99.641
SD$100.331
TN$96.461
TX$99.40–$107.888
UT$100.941
VA$102.05–$118.622
VI$105.751
VT$100.991
WA$107.08–$119.172
WI$97.661
WV$100.681
WY$103.301

See 57100 in every payment locality

How the 57100 rate is calculated

Each of 57100’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 · 57100

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.17

1.17 RVUs× 1.000 GPCI

Practice expense1.76

1.76 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

3.1500

Conversion factor

$33.4009

Medicare rate

$105.21

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

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,435

Code
57100
Physician work
1.17
Practice expense
1.76
Malpractice
0.22

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 57100 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0071.1782
Practice expense1.76× 1.0051.7688
Malpractice0.22× 2.2950.5049
Total RVUs3.4519
Conversion factor× 33.4009

Office rate, Chicago, IL$115.30

Office: (1.17 × 1.007 + 1.76 × 1.005 + 0.22 × 2.295) × $33.4009 = $115.30

Facility: (1.17 × 1.007 + 0.36 × 1.005 + 0.22 × 2.295) × $33.4009 = $68.30

Open 57100 in the RVU calculator

Payment rules and modifiers for 57100

The CMS indicators that decide how 57100 is paid alongside other services.

CMS payment indicators · 57100

Vaginal biopsy, simple mucosal sampling

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

57100 without 51 · national office

$105.21

Vaginal biopsy, simple mucosal sampling

57100-51 · Second procedure: 50%

$52.61

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 57100

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

Codes related to 57100
CodeHow it relatesOffice range, Chicago, IL
Same family
57105Vaginal biopsy, extensive mucosal samplingMore extensive vaginal mucosal biopsy; select according to the extent of biopsy documented.$190.56
Used instead
57135Vaginal lesion excision, cyst or tumorExcision of a vaginal cyst or tumor, rather than simple mucosal sampling.$264.37
Often billed with
88305Tissue pathology exam, level IV specimenMay represent microscopic examination of the vaginal biopsy specimen by the pathology service.$71.40
57421Colposcopy, entire vagina with biopsyVaginal colposcopy service that includes biopsy when performed; do not separately bill the same biopsy.$201.19

How 57100 has changed in Chicago, IL

57100 · Office / nonfacility

$115.30

Effective 2026-10-01

The base rate is $6.90 higher than on 2025-10-01, moving from $108.40 to $115.30 (6.4%).

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

    $108.40changed to$115.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.20 changed to 1.17
    • Practice expense RVU 1.70 changed to 1.76
    • Malpractice RVU 0.20 changed to 0.22
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $112.57changed to$108.40

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.73 changed to 1.70

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $110.73changed to$112.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.76changed to$110.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.72 changed to 1.73
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018

  5. January 1, 2023

    RVU23A

    $116.35changed to$113.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.70 changed to 1.72
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.02changed to$116.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.60 changed to 1.70
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $107.77changed to$113.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.38 changed to 1.60
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $103.35changed to$107.77

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.25 changed to 1.38
    • Malpractice RVU 0.19 changed to 0.18
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $99.52changed to$103.35

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.15 changed to 1.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $100.16changed to$99.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.16 changed to 1.15
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $99.36changed to$100.16

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.15 changed to 1.16
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $100.45changed to$99.36

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $99.95changed to$100.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $100.55changed to$99.95

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.14 changed to 1.15
    • Work GPCI 1.023 changed to 1.016
    • Practice expense GPCI 1.044 changed to 1.037
    • Malpractice GPCI 2.048 changed to 2.019

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $100.53changed to$100.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.24 changed to 1.14
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.030 changed to 1.023
    • Practice expense GPCI 1.051 changed to 1.044
    • Malpractice GPCI 2.077 changed to 2.048

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$100.53

  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$115.30$68.30RVU26D
2026-07-01$115.30$68.30RVU26C
2026-04-01$115.30$68.30RVU26B
2026-01-01$115.30$68.30RVU26A
2025-10-01$108.40$71.00RVU25D
2025-07-01$108.40$71.00RVU25C
2025-04-01$108.40$71.00RVU25B
2025-01-01$108.40$71.00RVU25A
2024-10-01$112.57$72.73RVU24D
2024-07-01$112.57$72.73RVU24C
2024-04-01$112.57$72.73RVU24B
2024-03-09$112.57$72.73RVU24AR
2024-01-01$110.73$71.54RVU24A
2023-10-01$113.76$72.81RVU23D
2023-07-01$113.76$72.81RVU23C
2023-04-01$113.76$72.81RVU23B
2023-01-01$113.76$72.81RVU23A
2022-10-01$116.35$74.44RVU22D
2022-07-01$116.35$74.44RVU22C
2022-04-01$116.35$74.44RVU22B
2022-01-01$116.35$74.44RVU22A
2021-10-01$113.02$74.41RVU21D
2021-07-01$113.02$74.41RVU21C
2021-04-01$113.02$74.41RVU21B
2021-01-01$113.02$74.41RVU21A
2020-10-01$107.77$75.53RVU20D
2020-07-01$107.77$75.53RVU20C
2020-04-01$107.77$75.53RVU20B
2020-01-01$107.77$75.53RVU20A
2019-10-01$103.35$76.15RVU19D
2019-07-01$103.35$76.15RVU19C
2019-04-01$103.35$76.15RVU19B
2019-01-01$103.35$76.15RVU19A
2018-10-01$99.52$76.44RVU18D
2018-07-01$99.52$76.44RVU18C
2018-04-01$99.52$76.44RVU18B
2018-01-01$99.52$76.44RVU18AR1
2017-10-01$100.16$77.11RVU17D
2017-07-01$100.16$77.11RVU17C
2017-04-01$100.16$77.11RVU17B
2017-01-01$100.16$77.11RVU17A
2016-10-01$99.36$76.34RVU16D
2016-07-01$99.36$76.34RVU16C
2016-04-01$99.36$76.34RVU16B
2016-01-01$99.36$76.34RVU16A
2015-10-01$100.45$77.34RVU15D
2015-07-01$100.45$77.34RVU15C
2015-04-01$99.95$76.96RVU15B
2015-01-01$99.95$76.96RVU15A
2014-10-01$100.55$77.74RVU14D
2014-07-01$100.55$77.74RVU14C
2014-04-01$100.55$77.74RVU14B
2014-01-01$100.55$77.74RVU14A
2013-10-01$100.53$76.57RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 57100 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

57100 billing questions

When should 57100 be chosen instead of 57105?

Use 57100 for a simple, limited vaginal mucosal biopsy. Use 57105 when the documented biopsy is extensive.

Can the pathology examination be reported separately?

The biopsy is the tissue-sampling service. When a laboratory performs microscopic examination of the specimen, that pathology service may be reported separately, such as with 88305 when the specimen and service meet that code’s criteria.

Can 57100 be reported with vaginal colposcopy code 57421?

Code 57421 includes vaginal or cervical biopsy when performed as part of the colposcopy service. Do not separately report 57100 for that same biopsy.

Is modifier 50 appropriate for biopsies from both sides of the vagina?

No. CMS identifies bilateral adjustment as inappropriate for 57100; modifier 50 should not be used.

What documentation supports 57100?

Record the vaginal site sampled, the clinical reason for sampling, and that a simple mucosal biopsy was performed. The operative or procedure note should distinguish sampling from a more extensive biopsy or excision.

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 57100PPRRVU2026_Oct_nonQPP.csv, line 6,435 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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