CPT code 57170: Diaphragm fitting, diaphragm or cervical cap2026 Medicare rate & RVUs in Wisconsin

Report this service when a clinician selects and assesses the fit of a contraceptive diaphragm or cervical cap for a patient.

CMS RVU26DEffective Oct 1, 2026One payment locality86 Medicare services in 2024

In Wisconsin, Medicare pays $67.53 for 57170 in the office and $37.45 when it’s performed in a hospital or facility.

$67.53Office (non-facility)
$37.45Hospital or facility
−7.3%vs the national office rate ($72.81)

Check a contract rate as a % of Medicare · 57170 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 57170 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Wisconsin
  2. What 57170 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 57170 covers

A clinician fits a contraceptive diaphragm or cervical cap by selecting an appropriate device size and assessing how it sits in the vagina. The service is typically performed in an office gynecology or family-planning visit. The fitting is distinct from placing a pessary for pelvic support or inserting an intrauterine device. Documentation should identify the barrier device fitted, the fitting assessment, and any relevant instruction provided to the patient.

Report 57170 for the fitting service, not for a general contraception discussion alone. The record should support that a diaphragm or cap was actually assessed for 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 multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 Wisconsin compares for 57170

Across 109 of 109 payment localities, the office rate for 57170 runs from $64.90 in Arkansas to $90.29 in San Benito County, CA. Wisconsin pays $67.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

57170 in Wisconsin vs other payment areas
  1. Wisconsin · this page$67.53
  2. Los Angeles, CA · California$79.14+$11.61
  3. Washington, DC area · District of Columbia$81.74+$14.21
  4. Miami, FL · Florida$82.53+$15.00
  5. Chicago, IL · Illinois$80.13+$12.60
  6. Manhattan, NY · New York$83.96+$16.43
  7. Alaska · Alaska$87.73+$20.20

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

Every other payment area

57170 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$65.78$38.30
ArkansasArkansas$64.90$37.93
ArizonaArizona$70.87$40.45
Bakersfield, CACalifornia$74.91$40.50
Chico, CACalifornia$74.46$40.05
El Centro, CACalifornia$74.49$40.08
Fresno, CACalifornia$74.46$40.05
Hanford, CACalifornia$74.46$40.05

57170 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.

$64.90

$87.73

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

View every state and territory as a table
57170 office rate range by state
State / territoryOffice rate rangeLocalities
AK$87.731
AL$65.781
AR$64.901
AZ$70.871
CA$74.46–$90.2929
CO$74.421
CT$77.441
DC$81.741
DE$71.971
FL$73.84–$82.533
GA$69.76–$74.582
GU$75.731
HI$75.731
IA$66.381
ID$66.981
IL$72.54–$80.134
IN$67.311
KS$66.541
KY$68.171
LA$68.25–$71.312
MA$74.21–$80.772
MD$73.13–$81.743
ME$67.77–$70.502
MI$70.22–$75.162
MN$70.151
MO$67.47–$71.013
MS$66.171
MT$72.801
NC$68.361
ND$69.641
NE$66.581
NH$73.691
NJ$77.99–$81.092
NM$70.761
NV$71.961
NY$69.34–$86.435
OH$69.571
OK$67.581
OR$71.08–$76.112
PA$69.43–$75.932
PR$73.151
RI$74.051
SC$69.141
SD$69.271
TN$66.911
TX$69.04–$74.808
UT$70.001
VA$70.60–$81.742
VI$73.151
VT$69.801
WA$73.92–$81.892
WI$67.531
WV$70.171
WY$71.421

See 57170 in every payment locality

How the 57170 rate is calculated

Each of 57170’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 · 57170

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.89

0.89 RVUs× 1.000 GPCI

Practice expense1.13

1.13 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

2.1800

Conversion factor

$33.4009

Medicare rate

$72.81

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

The exact Wisconsin inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,449

Code
57170
Physician work
0.89
Practice expense
1.13
Malpractice
0.16

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 57170 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work0.89× 1.0000.8900
Practice expense1.13× 0.9581.0825
Malpractice0.16× 0.3080.0493
Total RVUs2.0218
Conversion factor× 33.4009

Office rate, Wisconsin$67.53

Office: (0.89 × 1 + 1.13 × 0.958 + 0.16 × 0.308) × $33.4009 = $67.53

Facility: (0.89 × 1 + 0.19 × 0.958 + 0.16 × 0.308) × $33.4009 = $37.45

Open 57170 in the RVU calculator

Payment rules and modifiers for 57170

The CMS indicators that decide how 57170 is paid alongside other services.

CMS payment indicators · 57170

Diaphragm fitting, diaphragm or cervical cap

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

57170 without 51 · national office

$72.81

Diaphragm fitting, diaphragm or cervical cap

57170-51 · Second procedure: 50%

$36.41

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 57170 has changed in Wisconsin

57170 · Office / nonfacility

$67.53

Effective 2026-10-01

The base rate is $2.31 lower than on 2025-10-01, moving from $69.84 to $67.53 (3.3%).

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

    $69.84changed to$67.53

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.91 changed to 0.89
    • Practice expense RVU 1.25 changed to 1.13
    • Practice expense GPCI 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $72.72changed to$69.84

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.28 changed to 1.25
    • Malpractice RVU 0.15 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $71.53changed to$72.72

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $73.85changed to$71.53

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.17 changed to 0.15
    • Practice expense GPCI 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331
  5. January 1, 2023

    RVU23A

    $74.98changed to$73.85

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.29 changed to 1.28
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $72.09changed to$74.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.18 changed to 1.29
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $67.92changed to$72.09

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.98 changed to 1.18
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $62.80changed to$67.92

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.83 changed to 0.98
    • Malpractice RVU 0.11 changed to 0.13
    • Practice expense GPCI 0.957 changed to 0.949
    • Malpractice GPCI 0.347 changed to 0.322

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $57.91changed to$62.80

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.69 changed to 0.83

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $58.82changed to$57.91

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.71 changed to 0.69
    • Practice expense GPCI 0.956 changed to 0.957
    • Malpractice GPCI 0.457 changed to 0.347

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $58.75changed to$58.82

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.70 changed to 0.71
    • Practice expense GPCI 0.955 changed to 0.956
    • Malpractice GPCI 0.566 changed to 0.457

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $58.96changed to$58.75

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $58.66changed to$58.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $59.22changed to$58.66

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.13 changed to 0.11
    • Practice expense GPCI 0.958 changed to 0.955
    • Malpractice GPCI 0.557 changed to 0.566

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $58.39changed to$59.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.76 changed to 0.70
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.960 changed to 0.958
    • Malpractice GPCI 0.547 changed to 0.557

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$58.39

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$67.53$37.45RVU26D
2026-07-01$67.53$37.45RVU26C
2026-04-01$67.53$37.45RVU26B
2026-01-01$67.53$37.45RVU26A
2025-10-01$69.84$41.98RVU25D
2025-07-01$69.84$41.98RVU25C
2025-04-01$69.84$41.98RVU25B
2025-01-01$69.84$41.98RVU25A
2024-10-01$72.72$43.09RVU24D
2024-07-01$72.72$43.09RVU24C
2024-04-01$72.72$43.09RVU24B
2024-03-09$72.72$43.09RVU24AR
2024-01-01$71.53$42.39RVU24A
2023-10-01$73.85$43.91RVU23D
2023-07-01$73.85$43.91RVU23C
2023-04-01$73.85$43.91RVU23B
2023-01-01$73.85$43.91RVU23A
2022-10-01$74.98$44.34RVU22D
2022-07-01$74.98$44.34RVU22C
2022-04-01$74.98$44.34RVU22B
2022-01-01$74.98$44.34RVU22A
2021-10-01$72.09$44.81RVU21D
2021-07-01$72.09$44.81RVU21C
2021-04-01$72.09$44.81RVU21B
2021-01-01$72.09$44.81RVU21A
2020-10-01$67.92$46.00RVU20D
2020-07-01$67.92$46.00RVU20C
2020-04-01$67.92$46.00RVU20B
2020-01-01$67.92$46.00RVU20A
2019-10-01$62.80$46.24RVU19D
2019-07-01$62.80$46.24RVU19C
2019-04-01$62.80$46.24RVU19B
2019-01-01$62.80$46.24RVU19A
2018-10-01$57.91$46.19RVU18D
2018-07-01$57.91$46.19RVU18C
2018-04-01$57.91$46.19RVU18B
2018-01-01$57.91$46.19RVU18AR1
2017-10-01$58.82$47.16RVU17D
2017-07-01$58.82$47.16RVU17C
2017-04-01$58.82$47.16RVU17B
2017-01-01$58.82$47.16RVU17A
2016-10-01$58.75$47.12RVU16D
2016-07-01$58.75$47.12RVU16C
2016-04-01$58.75$47.12RVU16B
2016-01-01$58.75$47.12RVU16A
2015-10-01$58.96$47.29RVU15D
2015-07-01$58.96$47.29RVU15C
2015-04-01$58.66$47.06RVU15B
2015-01-01$58.66$47.06RVU15A
2014-10-01$59.22$47.55RVU14D
2014-07-01$59.22$47.55RVU14C
2014-04-01$59.22$47.55RVU14B
2014-01-01$59.22$47.55RVU14A
2013-10-01$58.39$46.30RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 57170 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

  • Abbotsford
  • Abrams
  • Adams
  • Adell
  • Albany
  • Algoma
  • Allens Grove
  • Allenton

Browse all communities in Wisconsin

57170 billing questions

How is 57170 different from 57160?

57170 is for fitting a contraceptive diaphragm or cervical cap. Code 57160 concerns insertion of a pessary or another device, commonly for pelvic support.

Does a contraception discussion alone support 57170?

No. The record should show that a diaphragm or cap was fitted and that its fit was assessed; discussion without fitting is not this service.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

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

CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.

What are the assistant and surgical-team payment rules?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery 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 57170PPRRVU2026_Oct_nonQPP.csv, line 6,449 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

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