CPT code 57426: Vaginal graft revision, laparoscopic approach2026 Medicare rate & RVUs in Missouri
Report this service when a surgeon laparoscopically revises or removes a previously placed prosthetic vaginal graft, such as mesh used in prolapse repair.
CMS doesn’t publish an office rate for 57426 in Missouri.
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 57426 covers
This procedure addresses a previously placed prosthetic vaginal graft through a laparoscopic approach. A gynecologist or urogynecologist may revise or remove graft material when mesh used in pelvic organ prolapse repair causes symptoms or requires surgical correction. The work is performed in an operating room and concerns the existing graft, rather than placement of a new support graft.
Select this code when the operative report documents laparoscopic access and the work performed on the vaginal graft. An operative note describing vaginal or open abdominal access points to a different approach code. Medicare treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included in its global period. When other procedures are performed in the same session, the standard multiple-procedure reduction pays the highest-valued procedure in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 57426 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $759.93 |
| Metropolitan St. Louis, MO | Unavailable | $764.90 |
| Rest of Missouri | Unavailable | $741.80 |
How the 57426 rate is calculated
Each of 57426’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 · 57426
RVUs × geographic indexes × conversion factor
Work13.94
13.94 RVUs× 1.000 GPCI
Practice expense6.96
6.96 RVUs× 1.000 GPCI
Malpractice2.33
2.33 RVUs× 1.000 GPCI
Adjusted RVUs
23.2300
Conversion factor
$33.4009
Medicare rate
$775.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57426
57426 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57426
Vaginal graft revision, 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57426
Vaginal graft revision, 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
57426 without 51 · national facility
$775.90
Vaginal graft revision, laparoscopic approach
57426-51 · Second procedure: 50%
$387.95
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%).
57426 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57295Vaginal graft revisionVaginal approach
- Both address an existing prosthetic vaginal graft. Choose 57295 for a vaginal approach; choose 57426 when the graft work is performed laparoscopically.
- 57296Vaginal graft revisionOpen abdominal approach
- Both address an existing prosthetic vaginal graft. Choose 57296 for an open abdominal approach and 57426 for a laparoscopic approach.
- 57425Laparoscopic colpopexyVaginal apex suspension
- Code 57425 covers laparoscopic vaginal suspension. Code 57426 covers laparoscopic revision or removal of a prosthetic vaginal graft already in place.
57426 billing questions
How does this differ from laparoscopic colpopexy?
Code 57426 addresses a prosthetic vaginal graft that is already in place. Code 57425 describes laparoscopic vaginal suspension, rather than revision of an existing graft.
Does removing the graft require a separate removal code?
Removal of the existing prosthetic vaginal graft is included when it is the work reported with 57426. Document what was removed or revised and the laparoscopic approach.
Can modifier 50 be used if work involves both sides of the pelvis?
No. Medicare’s bilateral adjustment does not apply to 57426, and modifier 50 is inappropriate for this service.
What postoperative care is included?
Medicare assigns 57426 a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can another surgeon assist with the laparoscopic revision?
An assistant at surgery may be paid. Co-surgeons require supporting documentation, while team surgery is 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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