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

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 Puerto Rico, Medicare pays $244.47 for 57135 in the office and $168.83 when it’s performed in a hospital or facility.

$244.47Office (non-facility)
$168.83Hospital or facility
+0.5%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $244.47. The RVUs are the same everywhere; the geographic indexes change the dollars.

57135 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$244.47
  2. Los Angeles, CA · California$267.21+$22.74
  3. Washington, DC area · District of Columbia$274.55+$30.08
  4. Miami, FL · Florida$272.39+$27.92
  5. Chicago, IL · Illinois$264.37+$19.90
  6. Manhattan, NY · New York$280.46+$35.99
  7. Alaska · Alaska$289.28+$44.81

Other areas in Puerto Rico 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.

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.

$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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 57135 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0002.6300
Practice expense4.19× 1.0114.2361
Malpractice0.46× 0.9850.4531
Total RVUs7.3192
Conversion factor× 33.4009

Office rate, Puerto Rico$244.47

Office: (2.63 × 1 + 4.19 × 1.011 + 0.46 × 0.985) × $33.4009 = $244.47

Facility: (2.63 × 1 + 1.95 × 1.011 + 0.46 × 0.985) × $33.4009 = $168.83

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

Codes related to 57135

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

Codes related to 57135
CodeHow it relatesOffice range, Puerto Rico
Used instead
57100Vaginal biopsy, simple mucosal samplingSimple vaginal mucosal biopsy is for sampling rather than complete removal of a cyst or tumor.$105.75
57105Vaginal biopsy, extensive mucosal samplingExtensive vaginal mucosal biopsy is for tissue sampling when the lesion is not excised.$176.37
57106Vaginectomy, partial wall removalRepresents partial vaginal wall removal when the service involves broader wall excision.No office rate
57110Vaginectomy, complete vaginal wall removalRepresents complete vaginal wall removal, a more extensive service than isolated lesion excision.No office rate

How 57135 has changed in Puerto Rico

57135 · Office / nonfacility

$244.47

Effective 2026-10-01

The base rate is $3.77 higher than on 2025-10-01, moving from $240.70 to $244.47 (1.6%).

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

    $240.70changed to$244.47

    • 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
    • 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

    $250.07changed to$240.70

    • 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

    $245.99changed to$250.07

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $255.10changed to$245.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.36 changed to 4.35
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $254.15changed to$255.10

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

  6. January 1, 2023

    RVU23A

    $259.16changed to$254.15

    • 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
    • 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

    $248.29changed to$259.16

    • 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.

  8. January 1, 2021

    RVU21A

    $231.01changed to$248.29

    • 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 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $209.59changed to$231.01

    • 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
    • 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

    $197.04changed to$209.59

    • 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.

  11. January 1, 2018

    RVU18AR1

    $178.92changed to$197.04

    • 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
    • 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

    $160.52changed to$178.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.38 changed to 2.40
    • 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

    $161.36changed to$160.52

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

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $160.55changed to$161.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $159.55changed to$160.55

    • 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
    • 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

    $155.57changed to$159.55

    • 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
    • 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: $155.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$244.47$168.83RVU26D
2026-07-01$244.47$168.83RVU26C
2026-04-01$244.47$168.83RVU26B
2026-01-01$244.47$168.83RVU26A
2025-10-01$240.70$184.35RVU25D
2025-07-01$240.70$184.35RVU25C
2025-04-01$240.70$184.35RVU25B
2025-01-01$240.70$184.35RVU25A
2024-10-01$250.07$189.74RVU24D
2024-07-01$250.07$189.74RVU24C
2024-04-01$250.07$189.74RVU24B
2024-03-09$250.07$189.74RVU24AR
2024-01-01$245.99$186.64RVU24A
2023-10-01$255.10$192.25RVU23D
2023-07-01$254.15$191.80RVU23C
2023-04-01$254.15$191.80RVU23B
2023-01-01$254.15$191.80RVU23A
2022-10-01$259.16$193.93RVU22D
2022-07-01$259.16$193.93RVU22C
2022-04-01$259.16$193.93RVU22B
2022-01-01$259.16$193.93RVU22A
2021-10-01$248.29$191.66RVU21D
2021-07-01$248.29$191.66RVU21C
2021-04-01$248.29$191.66RVU21B
2021-01-01$248.29$191.66RVU21A
2020-10-01$231.01$189.54RVU20D
2020-07-01$231.01$189.54RVU20C
2020-04-01$231.01$189.54RVU20B
2020-01-01$231.01$189.54RVU20A
2019-10-01$209.59$182.37RVU19D
2019-07-01$209.59$182.37RVU19C
2019-04-01$209.59$182.37RVU19B
2019-01-01$209.59$182.37RVU19A
2018-10-01$197.04$177.46RVU18D
2018-07-01$197.04$177.46RVU18C
2018-04-01$197.04$177.46RVU18B
2018-01-01$197.04$177.46RVU18AR1
2017-10-01$178.92$162.95RVU17D
2017-07-01$178.92$162.95RVU17C
2017-04-01$178.92$162.95RVU17B
2017-01-01$178.92$162.95RVU17A
2016-10-01$160.52$147.40RVU16D
2016-07-01$160.52$147.40RVU16C
2016-04-01$160.52$147.40RVU16B
2016-01-01$160.52$147.40RVU16A
2015-10-01$161.36$148.18RVU15D
2015-07-01$161.36$148.18RVU15C
2015-04-01$160.55$147.45RVU15B
2015-01-01$160.55$147.45RVU15A
2014-10-01$159.55$146.66RVU14D
2014-07-01$159.55$146.66RVU14C
2014-04-01$159.55$146.66RVU14B
2014-01-01$159.55$146.66RVU14A
2013-10-01$155.57$142.19RVU13D
2013-07-01$155.57$142.19RVU13C
2013-04-01$155.57$142.19RVU13B
2013-01-01$155.57$142.19RVU13AR

Price 57135 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

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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