CPT code 57421: Colposcopy, entire vagina with biopsy2026 Medicare rate & RVUs
Report this service when colposcopic examination of the entire vagina, including the cervix if present, includes directed biopsy of vaginal or cervical tissue.
Medicare pays $182.03 for 57421 nationally in the office and $109.22 in a hospital or facility. Local office rates run $161.67–$225.94.
Medicare rate · 57421
Colposcopy, entire vagina with biopsy
- Work RVUs
- 2.15
- Total RVUs
- 5.45
- Global days
- 000
National rate · 2026
$182.03
Office setting, before claim adjustments.
See every locality for 57421 →Billed by an NP, PA or therapist? →
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 10 sections
What 57421 covers
A clinician uses a colposcope to inspect the entire vaginal canal and, when present, the cervix, then takes directed tissue samples from abnormal areas. Gynecologists commonly perform this in an office or outpatient facility when evaluating abnormal vaginal cytology, suspected vaginal intraepithelial lesions, or visible lesions requiring histologic assessment, including in patients who have had a hysterectomy.
Report the service when the examination covers the entire vagina and includes biopsy; the code accounts for the colposcopic examination and biopsy work. The record should identify the examined anatomy, the abnormal area sampled, and the clinical reason for sampling. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures 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. Medicare does not pay an assistant at surgery for this service, and 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.
Where 57421 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$161.67 to $225.94
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $163.92 | $100.21 |
| Alaska | $217.89 | $140.35 |
| Arizona | $177.03 | $106.48 |
| Arkansas | $161.67 | $99.12 |
| Atlanta, GA | $186.61 | $112.63 |
| Austin, TX | $186.16 | $109.12 |
| Bakersfield, CA | $187.15 | $107.34 |
| Baltimore area, MD | $193.53 | $115.40 |
| Beaumont, TX | $172.38 | $106.12 |
| Brazoria, TX | $178.66 | $106.50 |
| Chicago, IL | $201.19 | $128.01 |
| Chico, CA | $185.98 | $106.18 |
| Colorado | $185.98 | $108.51 |
| Connecticut | $193.82 | $115.40 |
| Dallas, TX | $180.30 | $107.78 |
| Delaware | $179.82 | $107.88 |
| Detroit, MI | $188.29 | $118.03 |
| East St. Louis, IL | $188.56 | $121.58 |
| El Centro, CA | $186.05 | $106.25 |
| Fort Lauderdale, FL | $194.62 | $120.86 |
| Fort Worth, TX | $179.52 | $107.73 |
| Fresno, CA | $185.98 | $106.18 |
| Galveston, TX | $179.52 | $107.22 |
| Hanford, CA | $185.98 | $106.18 |
| Hawaii, Guam, HI | $189.31 | $106.52 |
| Houston, TX | $187.21 | $114.91 |
| Idaho | $166.95 | $99.96 |
| Indiana | $167.80 | $100.30 |
| Iowa | $165.40 | $98.77 |
| Kansas | $165.84 | $100.02 |
| Kentucky | $170.16 | $105.43 |
| King County, WA | $204.89 | $115.55 |
| Los Angeles, CA | $197.87 | $111.73 |
| Madera, CA | $185.98 | $106.18 |
| Manhattan, NY | $210.44 | $125.83 |
| Marin County, CA | $220.71 | $118.04 |
| Merced, CA | $185.98 | $106.18 |
| Metropolitan Boston, MA | $202.10 | $115.16 |
| Metropolitan Kansas City, MO | $175.84 | $107.47 |
| Metropolitan Philadelphia, PA | $189.98 | $114.18 |
| Metropolitan St. Louis, MO | $177.45 | $108.13 |
| Miami, FL | $207.43 | $131.63 |
| Minnesota | $174.95 | $100.02 |
| Mississippi | $165.00 | $102.31 |
| Modesto, CA | $185.98 | $106.18 |
| Montana | $182.01 | $109.19 |
| Napa, CA | $210.25 | $114.28 |
| Nebraska | $165.90 | $98.69 |
| Nevada | $179.79 | $106.90 |
| New Hampshire | $184.23 | $108.43 |
| New Mexico | $176.87 | $110.10 |
| New Orleans, LA | $178.27 | $109.75 |
| North Carolina | $170.53 | $102.59 |
| North Dakota | $173.70 | $100.89 |
| Northern New Jersey | $202.90 | $118.44 |
| NYC suburbs and Long Island, NY | $216.83 | $130.26 |
| Ohio | $173.78 | $107.30 |
| Oklahoma | $168.61 | $103.59 |
| Oxnard, CA | $196.26 | $110.20 |
| Portland, OR | $190.27 | $109.37 |
| Poughkeepsie and northern NYC suburbs, NY | $197.35 | $117.62 |
| Puerto Rico | $182.88 | $109.27 |
| Queens, NY | $210.34 | $124.27 |
| Redding, CA | $185.98 | $106.18 |
| Rest of California | $185.98 | $106.18 |
| Rest of Florida | $184.86 | $115.25 |
| Rest of Georgia | $174.34 | $109.39 |
| Rest of Illinois | $181.56 | $115.08 |
| Rest of Louisiana | $170.38 | $105.94 |
| Rest of Maine | $169.04 | $102.05 |
| Rest of Maryland | $182.76 | $109.07 |
| Rest of Massachusetts | $185.43 | $108.76 |
| Rest of Michigan | $175.48 | $109.00 |
| Rest of Missouri | $168.40 | $105.63 |
| Rest of New Jersey | $195.12 | $115.61 |
| Rest of New York | $173.06 | $103.89 |
| Rest of Oregon | $177.48 | $104.96 |
| Rest of Pennsylvania | $173.38 | $106.53 |
| Rest of Texas | $175.77 | $106.67 |
| Rest of Washington | $184.71 | $108.04 |
| Rhode Island | $185.06 | $109.84 |
| Riverside, CA | $190.50 | $110.70 |
| Sacramento, CA | $193.79 | $109.11 |
| Salinas, CA | $193.05 | $108.66 |
| San Benito County, CA | $225.94 | $120.95 |
| San Diego, CA | $196.62 | $109.53 |
| San Francisco, CA | $220.23 | $117.56 |
| San Luis Obispo, CA | $190.12 | $107.18 |
| Santa Clara County, CA | $223.99 | $119.00 |
| Santa Cruz, CA | $197.72 | $109.25 |
| Santa Maria, CA | $193.50 | $108.60 |
| Santa Rosa, CA | $199.61 | $110.20 |
| South Carolina | $172.62 | $105.34 |
| South Dakota | $172.72 | $99.91 |
| Southern Maine, ME | $175.99 | $103.83 |
| Stockton, CA | $185.98 | $106.18 |
| Suburban Chicago, IL | $195.96 | $121.18 |
| Tennessee | $166.79 | $100.60 |
| Utah | $174.83 | $106.39 |
| Vallejo, CA | $209.56 | $113.59 |
| Vermont | $174.14 | $102.06 |
| Virgin Islands, VI | $182.88 | $109.27 |
| Virginia | $176.28 | $104.70 |
| Visalia, CA | $185.98 | $106.18 |
| Washington, DC area | $204.62 | $118.85 |
| West Virginia | $175.48 | $112.20 |
| Wisconsin | $168.29 | $98.53 |
| Wyoming | $178.39 | $105.57 |
| Yuba City, CA | $185.98 | $106.18 |
57421 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.
$161.67
$217.89
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $217.89 | 1 |
| AL | $163.92 | 1 |
| AR | $161.67 | 1 |
| AZ | $177.03 | 1 |
| CA | $185.98–$225.94 | 29 |
| CO | $185.98 | 1 |
| CT | $193.82 | 1 |
| DC | $204.62 | 1 |
| DE | $179.82 | 1 |
| FL | $184.86–$207.43 | 3 |
| GA | $174.34–$186.61 | 2 |
| GU | $189.31 | 1 |
| HI | $189.31 | 1 |
| IA | $165.40 | 1 |
| ID | $166.95 | 1 |
| IL | $181.56–$201.19 | 4 |
| IN | $167.80 | 1 |
| KS | $165.84 | 1 |
| KY | $170.16 | 1 |
| LA | $170.38–$178.27 | 2 |
| MA | $185.43–$202.10 | 2 |
| MD | $182.76–$204.62 | 3 |
| ME | $169.04–$175.99 | 2 |
| MI | $175.48–$188.29 | 2 |
| MN | $174.95 | 1 |
| MO | $168.40–$177.45 | 3 |
| MS | $165.00 | 1 |
| MT | $182.01 | 1 |
| NC | $170.53 | 1 |
| ND | $173.70 | 1 |
| NE | $165.90 | 1 |
| NH | $184.23 | 1 |
| NJ | $195.12–$202.90 | 2 |
| NM | $176.87 | 1 |
| NV | $179.79 | 1 |
| NY | $173.06–$216.83 | 5 |
| OH | $173.78 | 1 |
| OK | $168.61 | 1 |
| OR | $177.48–$190.27 | 2 |
| PA | $173.38–$189.98 | 2 |
| PR | $182.88 | 1 |
| RI | $185.06 | 1 |
| SC | $172.62 | 1 |
| SD | $172.72 | 1 |
| TN | $166.79 | 1 |
| TX | $172.38–$187.21 | 8 |
| UT | $174.83 | 1 |
| VA | $176.28–$204.62 | 2 |
| VI | $182.88 | 1 |
| VT | $174.14 | 1 |
| WA | $184.71–$204.89 | 2 |
| WI | $168.29 | 1 |
| WV | $175.48 | 1 |
| WY | $178.39 | 1 |
How the 57421 rate is calculated
Each of 57421’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 · 57421
RVUs × geographic indexes × conversion factor
Work2.15
2.15 RVUs× 1.000 GPCI
Practice expense2.88
2.88 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
5.4500
Conversion factor
$33.4009
Medicare rate
$182.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57421
The CMS indicators that decide how 57421 is paid alongside other services.
CMS payment indicators · 57421
Colposcopy, entire vagina with biopsy
| 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
57421 without 51 · national office
$182.03
Colposcopy, entire vagina with biopsy
57421-51 · Second procedure: 50%
$91.02
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%).
57421 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57420Vaginal colposcopyWithout vaginal biopsy
- Both cover colposcopy of the entire vagina, including the cervix if present. Choose 57421 when biopsy is performed; 57420 is for the examination without biopsy.
- 57455Cervical biopsyColposcopy-guided biopsy
- 57455 covers cervical colposcopy with biopsy. Use 57421 for colposcopic examination of the entire vagina with biopsy.
- 57454Cervical colposcopyBiopsy and endocervical curettage
- 57454 describes cervical colposcopy with biopsy and endocervical curettage; 57421 involves examination of the entire vagina with biopsy.
57421 billing questions
When should 57421 be selected instead of 57420?
Use 57421 when colposcopic examination of the entire vagina includes biopsy. Code 57420 describes the corresponding examination without biopsy.
Can the biopsy be reported separately from the colposcopy?
The biopsy is included in 57421 when performed as part of the colposcopic service. Document the sampled site and the reason for biopsy.
How does 57421 differ from 57455?
57421 covers examination of the entire vagina, with the cervix if present, and biopsy. 57455 is for cervical colposcopy with biopsy, rather than the entire-vagina examination.
Should modifier 50 be appended for biopsy on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Can an assistant or co-surgeon be billed with 57421?
Medicare does not pay an assistant at surgery for this service. 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
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