CPT code 57160: Pessary fitting, intravaginal support device2026 Medicare rate & RVUs in New Jersey
Report pessary fitting and insertion when a clinician places an intravaginal support device to manage pelvic organ prolapse or stress urinary incontinence.
Medicare pays $75.47–$78.47 for 57160 in the office in New Jersey, from Rest of New Jersey to Northern New Jersey. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 57160 covers
A clinician, commonly a gynecologist or urogynecologist, selects and inserts an intravaginal support device such as a pessary. The visit may involve assessing fit and confirming that the device stays in position and can be tolerated. Pessaries are commonly used for pelvic organ prolapse and may be used for stress urinary incontinence. The service is typically performed in an office, though it can also occur in a facility.
Report the service for fitting and insertion of the support device, not for a contraceptive diaphragm fitting. Document the clinical indication, device selected, fitting and insertion, and relevant assessment of fit. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed 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. CMS lists no assistant-at-surgery payment; co-surgeons and team surgery are not permitted for this service.
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.
Where 57160 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | $78.47 | $43.60 |
| Rest of New Jersey | $75.47 | $42.65 |
How the 57160 rate is calculated
Each of 57160’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 · 57160
RVUs × geographic indexes × conversion factor
Work0.87
0.87 RVUs× 1.000 GPCI
Practice expense1.09
1.09 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
2.1100
Conversion factor
$33.4009
Medicare rate
$70.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57160
The CMS indicators that decide how 57160 is paid alongside other services.
CMS payment indicators · 57160
Pessary fitting, intravaginal support device
| 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) | 1 | Not paid (statutory restriction). |
| 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
57160 without 51 · national office
$70.48
Pessary fitting, intravaginal support device
57160-51 · Second procedure: 50%
$35.24
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%).
57160 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57170Diaphragm fittingDiaphragm or cervical cap
- 57170 is for fitting a diaphragm or cervical cap for contraception. Choose 57160 for fitting and inserting an intravaginal support device such as a pessary.
- 57156Brachytherapy insertionVaginal afterloading apparatus
- 57156 describes placement of a vaginal brachytherapy device for radiation treatment. It is not a support-device fitting or pessary insertion.
- 57150Vaginal infection treatmentIrrigation or medication
- 57150 is vaginal irrigation or medication treatment for vaginal infection. It does not describe fitting or inserting a support device.
57160 billing questions
When should 57160 be used instead of 57170?
Use 57160 for fitting and inserting an intravaginal support device such as a pessary. Use 57170 for fitting a diaphragm or cervical cap for contraception.
Can a separate E/M service be reported on the same date?
A separately identifiable E/M service may be reported when the documentation supports work beyond the fitting and insertion and the included same-day care. The device fitting itself is not a separate E/M service.
Should modifier 50 be appended for a pessary fitted to support both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting 57160?
Document the indication, the type of support device selected, the fitting and insertion, and the assessment of its fit and tolerance.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the service. CMS assigns no postoperative global days beyond the day of the procedure.
How is 57160 affected when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
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