CPT code 57156: Brachytherapy insertion, vaginal afterloading apparatus2026 Medicare rate & RVUs in Alabama
Report this service when a clinician inserts a vaginal afterloading applicator to prepare for intracavitary brachytherapy, such as treatment of a vaginal cuff.
In Alabama, Medicare pays $204.58 for 57156 in the office and $119.83 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 57156 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 57156 covers
A radiation oncologist or gynecologic oncologist places an afterloading applicator in the vagina to prepare for intracavitary brachytherapy. A vaginal cylinder is a common example, including for treatment directed to the vaginal cuff after hysterectomy for endometrial cancer. The service involves positioning the applicator for the planned treatment, rather than excision or treatment of a vaginal lesion.
Report the insertion when the record supports placement of a vaginal brachytherapy apparatus; document the indication and the applicator placed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted. Radiation delivery is a distinct service when performed and may be reported separately with the applicable delivery code.
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 Alabama compares for 57156
Across 109 of 109 payment localities, the office rate for 57156 runs from $202.16 in Arkansas to $287.29 in San Benito County, CA. Alabama pays $204.58. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$204.58
- Los Angeles, CA · California$248.67+$44.09
- Washington, DC area · District of Columbia$252.31+$47.73
- Miami, FL · Florida$239.81+$35.23
- Chicago, IL · Illinois$234.13+$29.55
- Manhattan, NY · New York$254.44+$49.86
- Alaska · Alaska$272.79+$68.21
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $202.16 | $118.95 |
| ArizonaArizona | $218.77 | $124.91 |
| Bakersfield, CACalifornia | $235.12 | $128.95 |
| Chico, CACalifornia | $234.43 | $128.27 |
| El Centro, CACalifornia | $234.46 | $128.30 |
| Fresno, CACalifornia | $234.43 | $128.27 |
| Hanford, CACalifornia | $234.43 | $128.27 |
| Madera, CACalifornia | $234.43 | $128.27 |
| Merced, CACalifornia | $234.43 | $128.27 |
| Modesto, CACalifornia | $234.43 | $128.27 |
| Napa, CACalifornia | $266.95 | $139.29 |
| Oxnard, CACalifornia | $247.12 | $132.63 |
| Redding, CACalifornia | $234.43 | $128.27 |
| Rest of CaliforniaCalifornia | $234.43 | $128.27 |
| Riverside, CACalifornia | $236.74 | $130.58 |
| Sacramento, CACalifornia | $244.75 | $132.10 |
| Salinas, CACalifornia | $243.80 | $131.53 |
| San Diego, CACalifornia | $248.53 | $132.69 |
| Marin County, CACalifornia | $281.30 | $144.73 |
| San Francisco, CACalifornia | $281.06 | $144.49 |
| San Benito County, CACalifornia | $287.29 | $147.62 |
| Santa Clara County, CACalifornia | $286.32 | $146.64 |
| San Luis Obispo, CACalifornia | $239.99 | $129.66 |
| Santa Cruz, CACalifornia | $250.16 | $132.47 |
| Santa Maria, CACalifornia | $244.44 | $131.50 |
| Santa Rosa, CACalifornia | $252.63 | $133.68 |
| Stockton, CACalifornia | $234.43 | $128.27 |
| Vallejo, CACalifornia | $266.61 | $138.94 |
| Visalia, CACalifornia | $234.43 | $128.27 |
| Yuba City, CACalifornia | $234.43 | $128.27 |
| ColoradoColorado | $231.57 | $128.51 |
| ConnecticutConnecticut | $236.96 | $132.64 |
| DelawareDelaware | $221.96 | $126.26 |
| Fort Lauderdale, FLFlorida | $231.13 | $133.01 |
| Rest of FloridaFlorida | $221.63 | $129.03 |
| Atlanta, GAGeorgia | $227.53 | $129.11 |
| Rest of GeorgiaGeorgia | $211.17 | $124.77 |
| Hawaii, Guam, HIHawaii | $238.54 | $128.41 |
| IowaIowa | $208.57 | $119.94 |
| IdahoIdaho | $209.75 | $120.64 |
| East St. Louis, ILIllinois | $220.56 | $131.44 |
| Rest of IllinoisIllinois | $216.49 | $128.05 |
| Suburban Chicago, ILIllinois | $233.30 | $133.83 |
| IndianaIndiana | $210.74 | $120.95 |
| KansasKansas | $207.90 | $120.33 |
| KentuckyKentucky | $208.84 | $122.73 |
| New Orleans, LALouisiana | $217.11 | $125.97 |
| Rest of LouisianaLouisiana | $208.63 | $122.90 |
| Metropolitan Boston, MAMassachusetts | $251.68 | $136.03 |
| Rest of MassachusettsMassachusetts | $230.61 | $128.62 |
| Baltimore area, MDMaryland | $236.28 | $132.35 |
| Rest of MarylandMaryland | $225.64 | $127.61 |
| Rest of MaineMaine | $210.79 | $121.68 |
| Southern Maine, MEMaine | $220.03 | $124.04 |
| Detroit, MIMichigan | $224.07 | $130.60 |
| Rest of MichiganMichigan | $213.45 | $125.01 |
| MinnesotaMinnesota | $222.60 | $122.92 |
| Metropolitan Kansas City, MOMissouri | $215.74 | $124.79 |
| Metropolitan St. Louis, MOMissouri | $217.60 | $125.38 |
| Rest of MissouriMissouri | $205.77 | $122.27 |
| MississippiMississippi | $203.99 | $120.59 |
| MontanaMontana | $223.77 | $126.91 |
| North CarolinaNorth Carolina | $212.59 | $122.22 |
| North DakotaNorth Dakota | $219.62 | $122.76 |
| NebraskaNebraska | $209.47 | $120.07 |
| New HampshireNew Hampshire | $228.21 | $127.38 |
| Northern New JerseyNew Jersey | $250.46 | $138.10 |
| Rest of New JerseyNew Jersey | $239.86 | $134.08 |
| New MexicoNew Mexico | $214.47 | $125.64 |
| NevadaNevada | $222.74 | $125.78 |
| NYC suburbs and Long Island, NYNew York | $259.83 | $144.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $241.48 | $135.41 |
| Queens, NYNew York | $256.01 | $141.52 |
| Rest of New YorkNew York | $215.24 | $123.22 |
| OhioOhio | $212.60 | $124.16 |
| OklahomaOklahoma | $208.39 | $121.89 |
| Portland, OROregon | $237.74 | $130.12 |
| Rest of OregonOregon | $221.19 | $124.71 |
| Metropolitan Philadelphia, PAPennsylvania | $232.01 | $131.18 |
| Rest of PennsylvaniaPennsylvania | $212.80 | $123.88 |
| Puerto RicoPuerto Rico | $225.10 | $127.17 |
| Rhode IslandRhode Island | $228.96 | $128.90 |
| South CarolinaSouth Carolina | $212.91 | $123.41 |
| South DakotaSouth Dakota | $219.13 | $122.27 |
| TennesseeTennessee | $208.78 | $120.73 |
| Austin, TXTexas | $230.66 | $128.18 |
| Beaumont, TXTexas | $211.65 | $123.51 |
| Brazoria, TXTexas | $221.78 | $125.79 |
| Dallas, TXTexas | $223.06 | $126.59 |
| Fort Worth, TXTexas | $221.86 | $126.35 |
| Galveston, TXTexas | $222.37 | $126.19 |
| Houston, TXTexas | $226.22 | $130.03 |
| Rest of TexasTexas | $216.51 | $124.59 |
| UtahUtah | $215.31 | $124.26 |
| VirginiaVirginia | $219.53 | $124.31 |
| Virgin Islands, VIUnited States Virgin Islands | $225.10 | $127.17 |
| VermontVermont | $219.03 | $123.13 |
| Rest of WashingtonWashington | $230.10 | $128.10 |
| King County, WAWashington | $256.22 | $137.37 |
| WisconsinWisconsin | $213.50 | $120.71 |
| West VirginiaWest Virginia | $209.88 | $125.70 |
| WyomingWyoming | $221.96 | $125.10 |
57156 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.
$202.16
$272.79
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $272.79 | 1 |
| AL | $204.58 | 1 |
| AR | $202.16 | 1 |
| AZ | $218.77 | 1 |
| CA | $234.43–$287.29 | 29 |
| CO | $231.57 | 1 |
| CT | $236.96 | 1 |
| DC | $252.31 | 1 |
| DE | $221.96 | 1 |
| FL | $221.63–$239.81 | 3 |
| GA | $211.17–$227.53 | 2 |
| GU | $238.54 | 1 |
| HI | $238.54 | 1 |
| IA | $208.57 | 1 |
| ID | $209.75 | 1 |
| IL | $216.49–$234.13 | 4 |
| IN | $210.74 | 1 |
| KS | $207.90 | 1 |
| KY | $208.84 | 1 |
| LA | $208.63–$217.11 | 2 |
| MA | $230.61–$251.68 | 2 |
| MD | $225.64–$252.31 | 3 |
| ME | $210.79–$220.03 | 2 |
| MI | $213.45–$224.07 | 2 |
| MN | $222.60 | 1 |
| MO | $205.77–$217.60 | 3 |
| MS | $203.99 | 1 |
| MT | $223.77 | 1 |
| NC | $212.59 | 1 |
| ND | $219.62 | 1 |
| NE | $209.47 | 1 |
| NH | $228.21 | 1 |
| NJ | $239.86–$250.46 | 2 |
| NM | $214.47 | 1 |
| NV | $222.74 | 1 |
| NY | $215.24–$259.83 | 5 |
| OH | $212.60 | 1 |
| OK | $208.39 | 1 |
| OR | $221.19–$237.74 | 2 |
| PA | $212.80–$232.01 | 2 |
| PR | $225.10 | 1 |
| RI | $228.96 | 1 |
| SC | $212.91 | 1 |
| SD | $219.13 | 1 |
| TN | $208.78 | 1 |
| TX | $211.65–$230.66 | 8 |
| UT | $215.31 | 1 |
| VA | $219.53–$252.31 | 2 |
| VI | $225.10 | 1 |
| VT | $219.03 | 1 |
| WA | $230.10–$256.22 | 2 |
| WI | $213.50 | 1 |
| WV | $209.88 | 1 |
| WY | $221.96 | 1 |
How the 57156 rate is calculated
Each of 57156’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 · 57156
RVUs × geographic indexes × conversion factor
Work2.62
2.62 RVUs× 1.000 GPCI
Practice expense3.87
3.87 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
6.7000
Conversion factor
$33.4009
Medicare rate
$223.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,447
- Code
- 57156
- Physician work
- 2.62
- Practice expense
- 3.87
- Malpractice
- 0.21
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.62 | × 1.000 | 2.6200 |
| Practice expense | 3.87 | × 0.875 | 3.3862 |
| Malpractice | 0.21 | × 0.566 | 0.1189 |
| Total RVUs | 6.1251 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$204.58
Office: (2.62 × 1 + 3.87 × 0.875 + 0.21 × 0.566) × $33.4009 = $204.58
Facility: (2.62 × 1 + 0.97 × 0.875 + 0.21 × 0.566) × $33.4009 = $119.83
Payment rules and modifiers for 57156
The CMS indicators that decide how 57156 is paid alongside other services.
CMS payment indicators · 57156
Brachytherapy insertion, vaginal afterloading apparatus
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57156 without 51 · national office
$223.79
Brachytherapy insertion, vaginal afterloading apparatus
57156-51 · Second procedure: 50%
$111.90
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%).
How 57156 has changed in Alabama
57156 · Office / nonfacility
$204.58
Effective 2026-10-01
The base rate is $0.18 lower than on 2025-10-01, moving from $204.76 to $204.58 (0.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$204.76changed to$204.58
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.69 changed to 2.62
- Practice expense RVU 4.05 changed to 3.87
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$208.88changed to$204.76
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.98 changed to 4.05
- Malpractice RVU 0.22 changed to 0.21
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$205.47changed to$208.88
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$214.26changed to$205.47
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.95 changed to 3.98
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$217.47changed to$214.26
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.84 changed to 3.95
- Malpractice RVU 0.20 changed to 0.22
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$213.39changed to$217.47
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.65 changed to 3.84
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$206.20changed to$213.39
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.25 changed to 3.65
- Malpractice RVU 0.19 changed to 0.20
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$197.68changed to$206.20
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.03 changed to 3.25
- Malpractice RVU 0.20 changed to 0.19
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$190.73changed to$197.68
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.82 changed to 3.03
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$190.73
Held through RVU18C, RVU18D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $204.58 | $119.83 | RVU26D |
| 2026-07-01 | $204.58 | $119.83 | RVU26C |
| 2026-04-01 | $204.58 | $119.83 | RVU26B |
| 2026-01-01 | $204.58 | $119.83 | RVU26A |
| 2025-10-01 | $204.76 | $138.42 | RVU25D |
| 2025-07-01 | $204.76 | $138.42 | RVU25C |
| 2025-04-01 | $204.76 | $138.42 | RVU25B |
| 2025-01-01 | $204.76 | $138.42 | RVU25A |
| 2024-10-01 | $208.88 | $140.33 | RVU24D |
| 2024-07-01 | $208.88 | $140.33 | RVU24C |
| 2024-04-01 | $208.88 | $140.33 | RVU24B |
| 2024-03-09 | $208.88 | $140.33 | RVU24AR |
| 2024-01-01 | $205.47 | $138.04 | RVU24A |
| 2023-10-01 | $214.26 | $144.34 | RVU23D |
| 2023-07-01 | $214.26 | $144.34 | RVU23C |
| 2023-04-01 | $214.26 | $144.34 | RVU23B |
| 2023-01-01 | $214.26 | $144.34 | RVU23A |
| 2022-10-01 | $217.47 | $145.87 | RVU22D |
| 2022-07-01 | $217.47 | $145.87 | RVU22C |
| 2022-04-01 | $217.47 | $145.87 | RVU22B |
| 2022-01-01 | $217.47 | $145.87 | RVU22A |
| 2021-10-01 | $213.39 | $145.84 | RVU21D |
| 2021-07-01 | $213.39 | $145.84 | RVU21C |
| 2021-04-01 | $213.39 | $145.84 | RVU21B |
| 2021-01-01 | $213.39 | $145.84 | RVU21A |
| 2020-10-01 | $206.20 | $147.49 | RVU20D |
| 2020-07-01 | $206.20 | $147.49 | RVU20C |
| 2020-04-01 | $206.20 | $147.49 | RVU20B |
| 2020-01-01 | $206.20 | $147.49 | RVU20A |
| 2019-10-01 | $197.68 | $144.75 | RVU19D |
| 2019-07-01 | $197.68 | $144.75 | RVU19C |
| 2019-04-01 | $197.68 | $144.75 | RVU19B |
| 2019-01-01 | $197.68 | $144.75 | RVU19A |
| 2018-10-01 | $190.73 | $143.63 | RVU18D |
| 2018-07-01 | $190.73 | $143.63 | RVU18C |
| 2018-04-01 | $190.73 | $143.63 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
57156 billing questions
How does this differ from 57155?
57156 is for placing a vaginal afterloading apparatus, commonly a vaginal cylinder. 57155 describes placement of a uterine tandem and/or vaginal ovoids for brachytherapy.
Does this code include radiation delivery?
It reports applicator insertion, not the radiation delivery itself. Report a separately performed delivery service with the applicable brachytherapy delivery code.
Is modifier 50 appropriate when treatment is directed to both sides?
No. CMS identifies bilateral adjustment as inappropriate for this service, so do not use modifier 50.
What documentation supports reporting 57156?
Document the brachytherapy indication, the vaginal afterloading apparatus placed, and the placement performed. The record should distinguish this service from placement of a uterine tandem or vaginal ovoids.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing are not permitted.
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
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