CPT code 57285: Paravaginal repair, vaginal approach2026 Medicare rate & RVUs in Massachusetts
Reports vaginal reconstruction of a lateral vaginal support defect, commonly performed for prolapse caused by detachment of the vaginal wall from its pelvic support.
CMS doesn’t publish an office rate for 57285 in Massachusetts.
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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What 57285 covers
A urogynecologist, gynecologist, or pelvic reconstructive surgeon uses a vaginal route to restore support where the lateral vaginal wall has separated from its pelvic attachment. The repair may address an associated cystocele when that correction is part of the same operation. It is typically performed in a facility operating room for vaginal prolapse caused by a paravaginal defect.
Choose this code when the operative report documents repair of the lateral support defect through the vagina, rather than a central anterior wall repair or an abdominal approach. The note should identify the defect, route, and repair performed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate for this 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.
Where 57285 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $657.11 |
| Rest of Massachusetts | Unavailable | $617.28 |
How the 57285 rate is calculated
Each of 57285’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 · 57285
RVUs × geographic indexes × conversion factor
Work11.31
11.31 RVUs× 1.000 GPCI
Practice expense5.20
5.20 RVUs× 1.000 GPCI
Malpractice1.90
1.90 RVUs× 1.000 GPCI
Adjusted RVUs
18.4100
Conversion factor
$33.4009
Medicare rate
$614.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57285
57285 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57285
Paravaginal repair, vaginal approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57285
Paravaginal repair, vaginal approach
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57285 without 51 · national facility
$614.91
Paravaginal repair, vaginal approach
57285-51 · Second procedure: 50%
$307.46
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%).
57285 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57284Paravaginal repairOpen abdominal approach
- Use 57285 for the vaginal route to a paravaginal defect; 57284 describes the open abdominal route.
- 57240Anterior repairAnterior compartment only
- 57240 addresses anterior vaginal wall repair, typically a central defect. This code is for restoring lateral vaginal support; a cystocele repaired as part of that work is included.
- 57260Combined vaginal repairAnterior and posterior walls
- 57260 combines anterior and posterior vaginal wall repairs. It is not the specific choice for a lateral paravaginal defect repaired vaginally.
57285 billing questions
How does this differ from 57284?
Both address a paravaginal support defect, but 57285 uses a vaginal route. Code 57284 is the open abdominal approach.
Can 57240 also be reported for a cystocele?
A cystocele corrected as part of the paravaginal repair is included in this service. Do not separately report 57240 for the same repair work; document any distinct, separately performed anterior wall repair clearly.
Can mesh insertion be reported with this repair?
When qualifying mesh or another prosthesis is inserted for the pelvic floor defect, 57267 is the related add-on code. The operative note should support the insertion and site.
Should modifier 50 be used for bilateral repair?
No. The code's anatomy and descriptor make modifier 50 inappropriate.
How are assistant and co-surgeon services treated?
CMS permits payment for an assistant at surgery and for co-surgeons. Team surgery is not permitted for this code.
What postoperative care is included?
The 90-day global period includes the preoperative visit on the day before surgery and 90 days of related postoperative care.
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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