CPT code 57295: Vaginal graft revision, vaginal approach2026 Medicare rate & RVUs

Medicare pays $448.57 for 57295 nationally in a facility.

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

What 57295 covers

A surgeon, commonly a urogynecologist or gynecologist, accesses a previously placed prosthetic graft through the vagina and revises or removes it. The service may address problems such as graft exposure, contraction, or pain after pelvic floor surgery. It is not the initial placement of a graft, and the approach is vaginal rather than abdominal.

Select this code when the operative report documents work on an existing vaginal graft and describes the vaginal route. Record the reason for revision, the graft involved, and the work performed, including whether graft material was removed. This major surgery has a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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 57295 pays more and less

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

109 of 109 payment localities

57295 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 57295 rate is calculated

Each of 57295’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 57295

57295 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

57295 compared with similar codes

How to choose

57296Vaginal graft revisionOpen abdominal approach

Both address revision or removal of a prosthetic vaginal graft. Choose based on whether the surgeon uses a vaginal or abdominal approach.

57287Sling revisionRemoval or revision

Use 57287 for revision or removal of a urethral sling. This code concerns a prosthetic vaginal graft used for pelvic support.

57285Paravaginal repairVaginal approach

Use 57285 for vaginal repair of a paravaginal defect. This code requires revision or removal of a previously placed vaginal graft.

Codes related to 57295

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