CPT code 57265: Vaginal prolapse repair, anterior and posterior with enterocele2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 57265 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 57265 covers

This vaginal operation repairs prolapse involving both the anterior and posterior vaginal walls and also repairs an enterocele, a peritoneal sac descending into the upper vagina. The anterior repair addresses defects such as a cystocele, while the posterior repair addresses posterior wall prolapse such as a rectocele. A gynecologist or urogynecologist typically performs the operation in a hospital or ambulatory surgical setting.

Report 57265 when the operative record supports repair of both vaginal compartments and an enterocele in the same operation; a combined repair without enterocele repair is distinguished by 57260. Documentation should identify the defects treated and describe the enterocele repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery 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.

Where 57265 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 57265 rate is calculated

Each of 57265’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.

Payment rules and modifiers for 57265

57265 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

57265 compared with similar codes

How to choose

57260Combined vaginal repairAnterior and posterior walls

Both represent combined anterior and posterior vaginal wall repair. Choose 57265 when the operation also repairs an enterocele; choose 57260 when it does not.

57268Enterocele repairVaginal approach

57268 is for vaginal repair of an enterocele as a separate procedure. It does not represent the combined anterior and posterior repairs included in 57265.

57240Anterior repairAnterior compartment only

57240 represents anterior vaginal wall repair alone. It is not the combined anterior and posterior repair with enterocele repair represented by 57265.

57250Posterior repairRectocele repair

57250 represents posterior vaginal wall repair alone. Use 57265 when the operation repairs both vaginal compartments and an enterocele.

Codes related to 57265

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

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

Open CMS sourceHow we calculate rates