CPT code 57423: Paravaginal repair, laparoscopic approach2026 Medicare rate & RVUs in Texas
Report laparoscopic repair when the surgeon restores lateral support to the anterior vaginal wall for a paravaginal defect, including associated cystocele repair.
CMS doesn’t publish an office rate for 57423 in Texas.
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 9 sections
What 57423 covers
A surgeon repairs a paravaginal defect laparoscopically by restoring the anterior vaginal wall’s lateral support where it has separated from the pelvic sidewall. The operation is commonly performed by a gynecologist or urogynecologist in a hospital or ambulatory surgery facility for pelvic organ prolapse. Cystocele repair performed as part of this repair is included; the code is not for an examination or for apical suspension alone.
Select the code when the operative report supports laparoscopic repair of the paravaginal defect, rather than a vaginal-route repair or a different prolapse procedure. Document the defect, approach, repair performed, and any associated cystocele work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery and co-surgeon reporting may be paid; 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 57423 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $823.94 |
| Beaumont, TX | Unavailable | $795.93 |
| Brazoria, TX | Unavailable | $803.69 |
| Dallas, TX | Unavailable | $812.21 |
| Fort Worth, TX | Unavailable | $811.29 |
| Galveston, TX | Unavailable | $808.39 |
| Houston, TX | Unavailable | $857.26 |
| Rest of Texas | Unavailable | $801.73 |
How the 57423 rate is calculated
Each of 57423’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 · 57423
RVUs × geographic indexes × conversion factor
Work15.68
15.68 RVUs× 1.000 GPCI
Practice expense6.23
6.23 RVUs× 1.000 GPCI
Malpractice2.67
2.67 RVUs× 1.000 GPCI
Adjusted RVUs
24.5800
Conversion factor
$33.4009
Medicare rate
$820.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57423
57423 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57423
Paravaginal repair, laparoscopic 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 · 57423
Paravaginal repair, laparoscopic 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
57423 without 51 · national facility
$820.99
Paravaginal repair, laparoscopic approach
57423-51 · Second procedure: 50%
$410.50
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%).
57423 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 57284Paravaginal repairOpen abdominal approach
- Choose 57284 for vaginal-route paravaginal defect repair; choose 57423 when the repair is performed laparoscopically.
- 57240Anterior repairAnterior compartment only
- Code 57240 describes anterior colporrhaphy for cystocele or anterior wall prolapse. Code 57423 is specific to laparoscopic restoration of paravaginal support.
- 57425Laparoscopic colpopexyVaginal apex suspension
- Code 57425 is for laparoscopic suspension of the vaginal apex. Code 57423 repairs lateral support of the anterior vaginal wall.
- 57426Vaginal graft revisionLaparoscopic approach
- Code 57426 is for laparoscopic revision of a prosthetic vaginal graft. It is not the code for an initial paravaginal defect repair.
57423 billing questions
How does this differ from code 57284?
Both address a paravaginal defect, but 57423 is for laparoscopic repair and 57284 is for the vaginal approach. The operative route determines the choice.
Can cystocele repair be reported separately?
Cystocele repair performed as part of the paravaginal repair is included. Do not separately report another code for the same repair work.
Is modifier 50 appropriate for bilateral repair?
No. CMS identifies bilateral adjustment as inapplicable for this code, and modifier 50 is inappropriate.
What documentation supports 57423?
The operative report should identify the paravaginal defect, confirm the laparoscopic approach, and describe the repair and any associated cystocele work.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons. Team surgery is not permitted for this code.
How is it paid when other procedures occur in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Related postoperative care is included in the 90-day global period.
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
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