CPT code 57135: Vaginal lesion excision, cyst or tumor2026 Medicare rate & RVUs in North Dakota

Excision of a vaginal cyst or tumor, such as a symptomatic Gartner duct cyst, when the lesion is removed rather than sampled.

CMS RVU26DEffective Oct 1, 2026One payment locality898 Medicare services in 2024

In North Dakota, Medicare pays $234.03 for 57135 in the office and $159.21 when it’s performed in a hospital or facility.

$234.03Office (non-facility)
$159.21Hospital or facility
−3.8%vs the national office rate ($243.16)

Check a contract rate as a % of Medicare · 57135 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 57135 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 57135 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 57135 covers

Code 57135 describes surgical removal of a cyst or tumor arising in the vagina, rather than a tissue sample taken only for diagnosis. A gynecologist typically performs the excision, removing the lesion from the vaginal wall and managing the resulting tissue defect. A symptomatic Gartner duct cyst or vaginal inclusion cyst is a familiar example. The procedure may take place in an office or an outpatient facility, depending on the lesion and the planned approach.

Choose this code when the documented service removes the vaginal cyst or tumor; document its site, clinical indication, extent of removal, and specimen findings when available. Related postoperative visits for 10 days are included in the minor-procedure global period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Report the service once; modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon or team-surgery reporting is 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 North Dakota compares for 57135

Across 109 of 109 payment localities, the office rate for 57135 runs from $215.97 in Arkansas to $307.55 in San Benito County, CA. North Dakota pays $234.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

57135 in North Dakota vs other payment areas
  1. North Dakota · this page$234.03
  2. Los Angeles, CA · California$267.21+$33.18
  3. Washington, DC area · District of Columbia$274.55+$40.52
  4. Miami, FL · Florida$272.39+$38.36
  5. Chicago, IL · Illinois$264.37+$30.34
  6. Manhattan, NY · New York$280.46+$46.43
  7. Alaska · Alaska$289.28+$55.25

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

Every other payment area

57135 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$219.00$153.53
ArkansasArkansas$215.97$151.71
ArizonaArizona$236.61$164.11
Bakersfield, CACalifornia$252.26$170.25
Chico, CACalifornia$250.96$168.96
El Centro, CACalifornia$251.03$169.03
Fresno, CACalifornia$250.96$168.96
Hanford, CACalifornia$250.96$168.96

57135 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.

$215.97

$289.28

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

View every state and territory as a table
57135 office rate range by state
State / territoryOffice rate rangeLocalities
AK$289.281
AL$219.001
AR$215.971
AZ$236.611
CA$250.96–$307.5529
CO$249.801
CT$258.921
DC$274.551
DE$240.371
FL$244.73–$272.393
GA$230.99–$248.752
GU$255.861
HI$255.861
IA$222.001
ID$223.871
IL$239.63–$264.374
IN$225.041
KS$222.101
KY$226.321
LA$226.42–$236.992
MA$248.86–$272.222
MD$244.46–$274.553
ME$226.15–$236.232
MI$232.96–$248.802
MN$236.401
MO$223.45–$236.473
MS$219.701
MT$243.131
NC$228.241
ND$234.031
NE$222.831
NH$246.981
NJ$261.04–$272.132
NM$234.631
NV$240.731
NY$231.60–$288.405
OH$231.111
OK$224.761
OR$238.04–$256.172
PA$230.84–$253.442
PR$244.471
RI$247.791
SC$230.221
SD$232.961
TN$223.311
TX$229.47–$249.708
UT$233.191
VA$236.26–$274.552
VI$244.471
VT$234.171
WA$248.05–$276.512
WI$226.651
WV$231.451
WY$239.161

See 57135 in every payment locality

How the 57135 rate is calculated

Each of 57135’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 · 57135

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.63

2.63 RVUs× 1.000 GPCI

Practice expense4.19

4.19 RVUs× 1.000 GPCI

Malpractice0.46

0.46 RVUs× 1.000 GPCI

Adjusted RVUs

7.2800

Conversion factor

$33.4009

Medicare rate

$243.16

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,444

Code
57135
Physician work
2.63
Practice expense
4.19
Malpractice
0.46

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 57135 in North Dakota
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0002.6300
Practice expense4.19× 1.0004.1900
Malpractice0.46× 0.4060.1868
Total RVUs7.0068
Conversion factor× 33.4009

Office rate, North Dakota$234.03

Office: (2.63 × 1 + 4.19 × 1 + 0.46 × 0.406) × $33.4009 = $234.03

Facility: (2.63 × 1 + 1.95 × 1 + 0.46 × 0.406) × $33.4009 = $159.21

Open 57135 in the RVU calculator

Payment rules and modifiers for 57135

57135 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57135

Vaginal lesion excision, cyst or tumor

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 · 57135

Vaginal lesion excision, cyst or tumor

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

57135 without 51 · national office

$243.16

Vaginal lesion excision, cyst or tumor

57135-51 · Second procedure: 50%

$121.58

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 57135 has changed in North Dakota

57135 · Office / nonfacility

$234.03

Effective 2026-10-01

The base rate is $1.36 higher than on 2025-10-01, moving from $232.67 to $234.03 (0.6%).

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

    $232.67changed to$234.03

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.70 changed to 2.63
    • Practice expense RVU 4.25 changed to 4.19
    • Malpractice RVU 0.47 changed to 0.46
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $242.25changed to$232.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.35 changed to 4.25
    • Malpractice RVU 0.44 changed to 0.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $238.30changed to$242.25

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $246.31changed to$238.30

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.36 changed to 4.35
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $249.89changed to$246.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.34 changed to 4.36
    • Malpractice RVU 0.42 changed to 0.44
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $238.85changed to$249.89

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.96 changed to 4.34
    • Malpractice RVU 0.43 changed to 0.42

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $222.45changed to$238.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.26 changed to 3.96
    • Malpractice RVU 0.42 changed to 0.43
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $203.06changed to$222.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.74 changed to 3.26
    • Malpractice RVU 0.36 changed to 0.42
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $190.76changed to$203.06

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.41 changed to 2.74
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $190.10changed to$190.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.40 changed to 2.41
    • Malpractice RVU 0.36 changed to 0.35
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $189.03changed to$190.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.38 changed to 2.40
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $190.07changed to$189.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.39 changed to 2.38

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $189.12changed to$190.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $189.69changed to$189.12

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.37 changed to 2.39
    • Malpractice RVU 0.42 changed to 0.36
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $188.06changed to$189.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.60 changed to 2.37
    • Malpractice RVU 0.44 changed to 0.42
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $188.06

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$234.03$159.21RVU26D
2026-07-01$234.03$159.21RVU26C
2026-04-01$234.03$159.21RVU26B
2026-01-01$234.03$159.21RVU26A
2025-10-01$232.67$176.71RVU25D
2025-07-01$232.67$176.71RVU25C
2025-04-01$232.67$176.71RVU25B
2025-01-01$232.67$176.71RVU25A
2024-10-01$242.25$182.33RVU24D
2024-07-01$242.25$182.33RVU24C
2024-04-01$242.25$182.33RVU24B
2024-03-09$242.25$182.33RVU24AR
2024-01-01$238.30$179.36RVU24A
2023-10-01$246.31$183.96RVU23D
2023-07-01$246.31$183.96RVU23C
2023-04-01$246.31$183.96RVU23B
2023-01-01$246.31$183.96RVU23A
2022-10-01$249.89$185.18RVU22D
2022-07-01$249.89$185.18RVU22C
2022-04-01$249.89$185.18RVU22B
2022-01-01$249.89$185.18RVU22A
2021-10-01$238.85$182.68RVU21D
2021-07-01$238.85$182.68RVU21C
2021-04-01$238.85$182.68RVU21B
2021-01-01$238.85$182.68RVU21A
2020-10-01$222.45$181.30RVU20D
2020-07-01$222.45$181.30RVU20C
2020-04-01$222.45$181.30RVU20B
2020-01-01$222.45$181.30RVU20A
2019-10-01$203.06$176.03RVU19D
2019-07-01$203.06$176.03RVU19C
2019-04-01$203.06$176.03RVU19B
2019-01-01$203.06$176.03RVU19A
2018-10-01$190.76$171.32RVU18D
2018-07-01$190.76$171.32RVU18C
2018-04-01$190.76$171.32RVU18B
2018-01-01$190.76$171.32RVU18AR1
2017-10-01$190.10$171.44RVU17D
2017-07-01$190.10$171.44RVU17C
2017-04-01$190.10$171.44RVU17B
2017-01-01$190.10$171.44RVU17A
2016-10-01$189.03$170.41RVU16D
2016-07-01$189.03$170.41RVU16C
2016-04-01$189.03$170.41RVU16B
2016-01-01$189.03$170.41RVU16A
2015-10-01$190.07$171.38RVU15D
2015-07-01$190.07$171.38RVU15C
2015-04-01$189.12$170.53RVU15B
2015-01-01$189.12$170.53RVU15A
2014-10-01$189.69$171.06RVU14D
2014-07-01$189.69$171.06RVU14C
2014-04-01$189.69$171.06RVU14B
2014-01-01$189.69$171.06RVU14A
2013-10-01$188.06$168.33RVU13D
2013-07-01$188.06$168.33RVU13C
2013-04-01$188.06$168.33RVU13B
2013-01-01$188.06$168.33RVU13AR

Price 57135 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

57135 billing questions

Can 57135 be used when the clinician only takes a biopsy?

No. Use 57135 when the cyst or tumor is excised; a diagnostic sample without removal is represented by a vaginal mucosal biopsy code, selected by the extent of sampling.

How does 57135 differ from vaginal wall removal codes?

57135 is for excision of a cyst or tumor. Codes for partial or complete vaginal wall removal describe more extensive removal of vaginal wall tissue, not removal of an isolated lesion.

Should modifier 50 be appended for lesions on both sides?

No. Modifier 50 is inappropriate for this service; report the excision once.

Are postoperative visits included?

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

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting are not permitted.

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction.

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 57135PPRRVU2026_Oct_nonQPP.csv, line 6,444 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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