FeeBase
Log inGet started
Menu

CPT code 57105: Vaginal biopsy, extensive mucosal sampling2026 Medicare rate & RVUs in Puerto Rico

Reports extensive sampling of abnormal vaginal mucosa for histologic assessment, such as broad or multifocal lesions, when the documented biopsy exceeds a simple mucosal biopsy.

CMS RVU26DEffective Oct 1, 2026One payment locality349 Medicare services in 2024

In Puerto Rico, Medicare pays $176.37 for 57105 in the office and $136.19 when it’s performed in a hospital or facility.

$176.37Office (non-facility)
$136.19Hospital or facility
+0.6%vs the national office rate ($175.35)

Check a contract rate as a % of Medicare · 57105 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 57105 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 57105 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 57105 covers

An extensive vaginal mucosal biopsy removes tissue from a broad or multifocal abnormal area for histologic evaluation. Gynecologists and gynecologic oncologists may perform it in an office or facility setting when examination identifies suspicious vaginal mucosa, such as persistent lesions or changes concerning for vaginal intraepithelial neoplasia or malignancy. The code reflects the extent of the biopsy service, not simply a stated number of tissue fragments.

Choose 57105 rather than 57100 when the documented biopsy work is extensive. Record the lesion distribution and appearance, sites sampled, and extent of tissue collection. The code has a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50 for bilateral vaginal biopsy. 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 Puerto Rico compares for 57105

Across 109 of 109 payment localities, the office rate for 57105 runs from $154.84 in Arkansas to $224.02 in San Benito County, CA. Puerto Rico pays $176.37. The RVUs are the same everywhere; the geographic indexes change the dollars.

57105 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$176.37
  2. Los Angeles, CA · California$193.66+$17.29
  3. Washington, DC area · District of Columbia$198.81+$22.44
  4. Miami, FL · Florida$196.62+$20.25
  5. Chicago, IL · Illinois$190.56+$14.19
  6. Manhattan, NY · New York$202.87+$26.50
  7. Alaska · Alaska$205.79+$29.42

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

Every other payment area

57105 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$157.13$122.35
ArkansasArkansas$154.84$120.70
ArizonaArizona$170.43$131.92
Bakersfield, CACalifornia$182.45$138.89
Chico, CACalifornia$181.53$137.97
El Centro, CACalifornia$181.59$138.02
Fresno, CACalifornia$181.53$137.97
Hanford, CACalifornia$181.53$137.97

57105 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.

$154.84

$205.79

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

View every state and territory as a table
57105 office rate range by state
State / territoryOffice rate rangeLocalities
AK$205.791
AL$157.131
AR$154.841
AZ$170.431
CA$181.53–$224.0229
CO$180.511
CT$187.091
DC$198.811
DE$173.231
FL$176.17–$196.623
GA$165.86–$179.462
GU$185.451
HI$185.451
IA$159.571
ID$160.941
IL$172.20–$190.564
IN$161.841
KS$159.561
KY$162.481
LA$162.52–$170.512
MA$179.73–$197.342
MD$176.31–$198.813
ME$162.58–$170.322
MI$167.42–$179.152
MN$170.711
MO$160.23–$170.213
MS$157.531
MT$175.331
NC$164.171
ND$168.811
NE$160.221
NH$178.391
NJ$188.59–$196.892
NM$168.641
NV$173.621
NY$166.70–$208.765
OH$166.091
OK$161.391
OR$171.65–$185.382
PA$165.93–$182.912
PR$176.371
RI$178.791
SC$165.531
SD$168.041
TN$160.461
TX$164.89–$180.458
UT$167.781
VA$170.29–$198.812
VI$176.371
VT$168.831
WA$179.16–$200.592
WI$163.211
WV$166.021
WY$172.491

See 57105 in every payment locality

How the 57105 rate is calculated

Each of 57105’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 · 57105

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.70

1.70 RVUs× 1.000 GPCI

Practice expense3.22

3.22 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

5.2500

Conversion factor

$33.4009

Medicare rate

$175.35

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,436

Code
57105
Physician work
1.70
Practice expense
3.22
Malpractice
0.33

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 57105 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.70× 1.0001.7000
Practice expense3.22× 1.0113.2554
Malpractice0.33× 0.9850.3251
Total RVUs5.2805
Conversion factor× 33.4009

Office rate, Puerto Rico$176.37

Office: (1.7 × 1 + 3.22 × 1.011 + 0.33 × 0.985) × $33.4009 = $176.37

Facility: (1.7 × 1 + 2.03 × 1.011 + 0.33 × 0.985) × $33.4009 = $136.19

Open 57105 in the RVU calculator

Payment rules and modifiers for 57105

57105 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57105

Vaginal biopsy, extensive mucosal sampling

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 57105

Vaginal biopsy, extensive mucosal sampling

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

57105 without 51 · national office

$175.35

Vaginal biopsy, extensive mucosal sampling

57105-51 · Second procedure: 50%

$87.68

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 57105

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

Codes related to 57105
CodeHow it relatesOffice range, Puerto Rico
Same family
57100Vaginal biopsy, simple mucosal samplingSibling code for simple vaginal mucosal biopsy rather than extensive sampling.$105.75
Used instead
57421Colposcopy, entire vagina with biopsyUsed for vaginal colposcopy with biopsy when that combined service is performed.$182.88
57135Vaginal lesion excision, cyst or tumorUsed to excise a vaginal cyst or tumor rather than sample mucosa.$244.47
56605Vulvar biopsy, first lesion sampledBiopsy code for vulvar or perineal tissue, not vaginal mucosa.$93.99

How 57105 has changed in Puerto Rico

57105 · Office / nonfacility

$176.37

Effective 2026-10-01

The base rate is $4.68 higher than on 2025-10-01, moving from $171.69 to $176.37 (2.7%).

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

    $171.69changed to$176.37

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.74 changed to 1.70
    • Practice expense RVU 3.27 changed to 3.22
    • Malpractice RVU 0.28 changed to 0.33
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $179.36changed to$171.69

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.34 changed to 3.27
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $176.43changed to$179.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $181.71changed to$176.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.33 changed to 3.34
    • Malpractice RVU 0.27 changed to 0.29
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $180.96changed to$181.71

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $185.59changed to$180.96

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $177.29changed to$185.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.06 changed to 3.33
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $165.19changed to$177.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.55 changed to 3.06
    • Malpractice RVU 0.27 changed to 0.26
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $151.46changed to$165.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.19 changed to 2.55
    • Malpractice RVU 0.26 changed to 0.27
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $140.06changed to$151.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.88 changed to 2.19

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $126.19changed to$140.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $112.23changed to$126.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.88
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $112.74changed to$112.23

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $112.18changed to$112.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $110.91changed to$112.18

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.85 changed to 1.87
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $108.71changed to$110.91

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.04 changed to 1.85
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$176.37$136.19RVU26D
2026-07-01$176.37$136.19RVU26C
2026-04-01$176.37$136.19RVU26B
2026-01-01$176.37$136.19RVU26A
2025-10-01$171.69$143.35RVU25D
2025-07-01$171.69$143.35RVU25C
2025-04-01$171.69$143.35RVU25B
2025-01-01$171.69$143.35RVU25A
2024-10-01$179.36$148.52RVU24D
2024-07-01$179.36$148.52RVU24C
2024-04-01$179.36$148.52RVU24B
2024-03-09$179.36$148.52RVU24AR
2024-01-01$176.43$146.10RVU24A
2023-10-01$181.71$149.95RVU23D
2023-07-01$180.96$149.44RVU23C
2023-04-01$180.96$149.44RVU23B
2023-01-01$180.96$149.44RVU23A
2022-10-01$185.59$151.75RVU22D
2022-07-01$185.59$151.75RVU22C
2022-04-01$185.59$151.75RVU22B
2022-01-01$185.59$151.75RVU22A
2021-10-01$177.29$147.39RVU21D
2021-07-01$177.29$147.39RVU21C
2021-04-01$177.29$147.39RVU21B
2021-01-01$177.29$147.39RVU21A
2020-10-01$165.19$142.27RVU20D
2020-07-01$165.19$142.27RVU20C
2020-04-01$165.19$142.27RVU20B
2020-01-01$165.19$142.27RVU20A
2019-10-01$151.46$135.49RVU19D
2019-07-01$151.46$135.49RVU19C
2019-04-01$151.46$135.49RVU19B
2019-01-01$151.46$135.49RVU19A
2018-10-01$140.06$130.27RVU18D
2018-07-01$140.06$130.27RVU18C
2018-04-01$140.06$130.27RVU18B
2018-01-01$140.06$130.27RVU18AR1
2017-10-01$126.19$117.90RVU17D
2017-07-01$126.19$117.90RVU17C
2017-04-01$126.19$117.90RVU17B
2017-01-01$126.19$117.90RVU17A
2016-10-01$112.23$105.16RVU16D
2016-07-01$112.23$105.16RVU16C
2016-04-01$112.23$105.16RVU16B
2016-01-01$112.23$105.16RVU16A
2015-10-01$112.74$105.90RVU15D
2015-07-01$112.74$105.90RVU15C
2015-04-01$112.18$105.37RVU15B
2015-01-01$112.18$105.37RVU15A
2014-10-01$110.91$104.47RVU14D
2014-07-01$110.91$104.47RVU14C
2014-04-01$110.91$104.47RVU14B
2014-01-01$110.91$104.47RVU14A
2013-10-01$108.71$101.79RVU13D
2013-07-01$108.71$101.79RVU13C
2013-04-01$108.71$101.79RVU13B
2013-01-01$108.71$101.79RVU13AR

Price 57105 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

57105 billing questions

How does 57105 differ from 57100?

57105 is for extensive vaginal mucosal biopsy work; 57100 describes a simple biopsy. Document the extent and distribution of the sampled abnormal mucosa rather than relying only on the number of tissue fragments.

Can 57105 be reported with vaginal colposcopy and biopsy?

When 57421 is reported for vaginal colposcopy with biopsies, those biopsies are included in that service. Do not separately report 57105 for the same biopsy work.

Should modifier 50 be used for biopsies on both sides of the vagina?

No. The CMS bilateral adjustment does not apply to 57105, and modifier 50 is inappropriate.

Are related postoperative visits included?

Yes. Related postoperative visits during the 10-day global period are included in 57105.

What documentation supports choosing the extensive-biopsy code?

Document the abnormal mucosa's appearance and distribution, the sites sampled, and the extent of tissue collection. The record should show why the service was extensive rather than a simple vaginal mucosal biopsy.

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 57105PPRRVU2026_Oct_nonQPP.csv, line 6,436 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 57105 pays in Puerto Rico?

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 57105 and the rest of your codes on one sheet

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

Join the waitlist