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CPT code 57156: Brachytherapy insertion, vaginal afterloading apparatus2026 Medicare rate & RVUs in Houston, TX

Report this service when a clinician inserts a vaginal afterloading applicator to prepare for intracavitary brachytherapy, such as treatment of a vaginal cuff.

CMS RVU26DEffective Oct 1, 2026One payment locality14.5K Medicare services in 2024

In Houston, TX, Medicare pays $226.22 for 57156 in the office and $130.03 when it’s performed in a hospital or facility.

$226.22Office (non-facility)
$130.03Hospital or facility
+1.1%vs the national office rate ($223.79)

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.

We’ll open 57156 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 57156 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 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 Houston, TX 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. Houston, TX pays $226.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

57156 in Houston, TX vs other payment areas
  1. Houston, TX · this page$226.22
  2. Austin, TX · Texas$230.66+$4.44
  3. Beaumont, TX · Texas$211.65−$14.57
  4. Brazoria, TX · Texas$221.78−$4.44
  5. Dallas, TX · Texas$223.06−$3.16
  6. Fort Worth, TX · Texas$221.86−$4.36
  7. Galveston, TX · Texas$222.37−$3.85

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

Every other payment area

57156 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$216.51$124.59
Los Angeles, CACalifornia$248.67$134.08
Washington, DC areaDistrict of Columbia$252.31$138.21
Miami, FLFlorida$239.81$138.98
Chicago, ILIllinois$234.13$136.78
Manhattan, NYNew York$254.44$141.88
AlaskaAlaska$272.79$169.64
AlabamaAlabama$204.58$119.83

57156 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.

$202.16

$272.79

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

View every state and territory as a table
57156 office rate range by state
State / territoryOffice rate rangeLocalities
AK$272.791
AL$204.581
AR$202.161
AZ$218.771
CA$234.43–$287.2929
CO$231.571
CT$236.961
DC$252.311
DE$221.961
FL$221.63–$239.813
GA$211.17–$227.532
GU$238.541
HI$238.541
IA$208.571
ID$209.751
IL$216.49–$234.134
IN$210.741
KS$207.901
KY$208.841
LA$208.63–$217.112
MA$230.61–$251.682
MD$225.64–$252.313
ME$210.79–$220.032
MI$213.45–$224.072
MN$222.601
MO$205.77–$217.603
MS$203.991
MT$223.771
NC$212.591
ND$219.621
NE$209.471
NH$228.211
NJ$239.86–$250.462
NM$214.471
NV$222.741
NY$215.24–$259.835
OH$212.601
OK$208.391
OR$221.19–$237.742
PA$212.80–$232.012
PR$225.101
RI$228.961
SC$212.911
SD$219.131
TN$208.781
TX$211.65–$230.668
UT$215.311
VA$219.53–$252.312
VI$225.101
VT$219.031
WA$230.10–$256.222
WI$213.501
WV$209.881
WY$221.961

See 57156 in every payment locality

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

Office or facility?

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 57156 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.62× 1.0082.6410
Practice expense3.87× 0.9933.8429
Malpractice0.21× 1.3760.2890
Total RVUs6.7728
Conversion factor× 33.4009

Office rate, Houston, TX$226.22

Office: (2.62 × 1.008 + 3.87 × 0.993 + 0.21 × 1.376) × $33.4009 = $226.22

Facility: (2.62 × 1.008 + 0.97 × 0.993 + 0.21 × 1.376) × $33.4009 = $130.03

Open 57156 in the RVU calculator

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

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)0Not paid without supporting documentation.
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

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%).

When to use modifier 51

Codes related to 57156

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

Codes related to 57156
CodeHow it relatesOffice range, Houston, TX
Used instead
57155Brachytherapy applicator, uterine tandem and vaginal ovoidsUsed for brachytherapy applicator placement involving a uterine tandem and/or vaginal ovoids.$403.09
Often billed with
77770HDR brachytherapy, single channel, per fractionMay report remote afterloading brachytherapy delivery when performed with a single channel.$349.54
77771HDR brachytherapy, interstitial or intracavitary, intermediateMay report remote afterloading brachytherapy delivery when performed with two to twelve channels.$611.94
77772HDR brachytherapy, more than 12 channelsMay report remote afterloading brachytherapy delivery when performed with more than twelve channels.$916.08

How 57156 has changed in Houston, TX

57156 · Office / nonfacility

$226.22

Effective 2026-10-01

The base rate is $2.98 lower than on 2025-10-01, moving from $229.20 to $226.22 (1.3%).

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

    $229.20changed to$226.22

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $234.00changed to$229.20

    • 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.

  3. March 9, 2024

    RVU24AR

    $230.18changed to$234.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $237.85changed to$230.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.95 changed to 3.98
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $239.04changed to$237.85

    • 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
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $234.20changed to$239.04

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.65 changed to 3.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $225.54changed to$234.20

    • 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
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $216.14changed to$225.54

    • 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
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $208.25changed to$216.14

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.82 changed to 3.03

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $205.21changed to$208.25

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.76 changed to 2.82
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $203.31changed to$205.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.73 changed to 2.76
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $202.57changed to$203.31

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.67 changed to 2.73
    • Malpractice RVU 0.22 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $201.56changed to$202.57

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $199.70changed to$201.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.63 changed to 2.67
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $194.34changed to$199.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.78 changed to 2.63
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $194.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$226.22$130.03RVU26D
2026-07-01$226.22$130.03RVU26C
2026-04-01$226.22$130.03RVU26B
2026-01-01$226.22$130.03RVU26A
2025-10-01$229.20$152.63RVU25D
2025-07-01$229.20$152.63RVU25C
2025-04-01$229.20$152.63RVU25B
2025-01-01$229.20$152.63RVU25A
2024-10-01$234.00$154.87RVU24D
2024-07-01$234.00$154.87RVU24C
2024-04-01$234.00$154.87RVU24B
2024-03-09$234.00$154.87RVU24AR
2024-01-01$230.18$152.34RVU24A
2023-10-01$237.85$156.94RVU23D
2023-07-01$237.85$156.94RVU23C
2023-04-01$237.85$156.94RVU23B
2023-01-01$237.85$156.94RVU23A
2022-10-01$239.04$156.07RVU22D
2022-07-01$239.04$156.07RVU22C
2022-04-01$239.04$156.07RVU22B
2022-01-01$239.04$156.07RVU22A
2021-10-01$234.20$155.93RVU21D
2021-07-01$234.20$155.93RVU21C
2021-04-01$234.20$155.93RVU21B
2021-01-01$234.20$155.93RVU21A
2020-10-01$225.54$158.17RVU20D
2020-07-01$225.54$158.17RVU20C
2020-04-01$225.54$158.17RVU20B
2020-01-01$225.54$158.17RVU20A
2019-10-01$216.14$155.96RVU19D
2019-07-01$216.14$155.96RVU19C
2019-04-01$216.14$155.96RVU19B
2019-01-01$216.14$155.96RVU19A
2018-10-01$208.25$154.70RVU18D
2018-07-01$208.25$154.70RVU18C
2018-04-01$208.25$154.70RVU18B
2018-01-01$208.25$154.70RVU18AR1
2017-10-01$205.21$153.06RVU17D
2017-07-01$205.21$153.06RVU17C
2017-04-01$205.21$153.06RVU17B
2017-01-01$205.21$153.06RVU17A
2016-10-01$203.31$151.81RVU16D
2016-07-01$203.31$151.81RVU16C
2016-04-01$203.31$151.81RVU16B
2016-01-01$203.31$151.81RVU16A
2015-10-01$202.57$151.23RVU15D
2015-07-01$202.57$151.23RVU15C
2015-04-01$201.56$150.48RVU15B
2015-01-01$201.56$150.48RVU15A
2014-10-01$199.70$150.07RVU14D
2014-07-01$199.70$150.07RVU14C
2014-04-01$199.70$150.07RVU14B
2014-01-01$199.70$150.07RVU14A
2013-10-01$194.34$142.86RVU13D
2013-07-01$194.34$142.86RVU13C
2013-04-01$194.34$142.86RVU13B
2013-01-01$194.34$142.86RVU13AR

Price 57156 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 57156PPRRVU2026_Oct_nonQPP.csv, line 6,447 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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