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CPT code 57454: Cervical colposcopy, biopsy and endocervical curettage2026 Medicare rate & RVUs in Puerto Rico

Report this service when colposcopy for an abnormal cervical screening result includes directed cervical biopsy and endocervical curettage.

CMS RVU26DEffective Oct 1, 2026One payment locality13.9K Medicare services in 2024

In Puerto Rico, Medicare pays $166.65 for 57454 in the office and $119.03 when it’s performed in a hospital or facility.

$166.65Office (non-facility)
$119.03Hospital or facility
+0.4%vs the national office rate ($166.00)

Check a contract rate as a % of Medicare · 57454 nationwide

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

We’ll open 57454 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 57454 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 57454 covers

A clinician uses a colposcope to examine the cervix and directs one or more tissue samples from suspicious areas, then obtains endocervical tissue by curettage. Gynecologists commonly perform the procedure in an office or outpatient setting after abnormal cervical cytology or a high-risk HPV result. The cervical biopsy and endocervical curettage specimens are typically sent for histologic examination.

Select this code when both cervical biopsy and endocervical curettage are performed with colposcopy; document the examination, biopsy sites, and curettage. The code includes these diagnostic sampling services, so do not separately report the same biopsy or curettage. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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.

How Puerto Rico compares for 57454

Across 109 of 109 payment localities, the office rate for 57454 runs from $148.69 in Arkansas to $202.91 in Alaska. Puerto Rico pays $166.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

57454 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$166.65
  2. Los Angeles, CA · California$178.68+$12.03
  3. Washington, DC area · District of Columbia$185.28+$18.63
  4. Miami, FL · Florida$189.58+$22.93
  5. Chicago, IL · Illinois$184.22+$17.57
  6. Manhattan, NY · New York$191.13+$24.48
  7. Alaska · Alaska$202.91+$36.26

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

57454 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$150.60$109.39
ArkansasArkansas$148.69$108.24
ArizonaArizona$161.70$116.06
Bakersfield, CACalifornia$169.59$117.98
Chico, CACalifornia$168.47$116.85
El Centro, CACalifornia$168.53$116.92
Fresno, CACalifornia$168.47$116.85
Hanford, CACalifornia$168.47$116.85

57454 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$148.69

$202.91

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
57454 office rate range by state
State / territoryOffice rate rangeLocalities
AK$202.911
AL$150.601
AR$148.691
AZ$161.701
CA$168.47–$202.1029
CO$168.901
CT$176.241
DC$185.281
DE$164.111
FL$169.34–$189.583
GA$160.27–$170.142
GU$170.901
HI$170.901
IA$151.421
ID$152.821
IL$166.84–$184.224
IN$153.531
KS$152.001
KY$156.341
LA$156.61–$163.292
MA$168.58–$182.542
MD$166.59–$185.283
ME$154.81–$160.382
MI$161.04–$172.482
MN$158.821
MO$155.05–$162.343
MS$151.841
MT$165.981
NC$156.031
ND$158.071
NE$151.781
NH$167.481
NJ$177.40–$183.982
NM$162.311
NV$163.851
NY$158.19–$196.825
OH$159.431
OK$154.801
OR$161.73–$172.322
PA$158.97–$173.102
PR$166.651
RI$168.541
SC$158.161
SD$157.131
TN$152.831
TX$158.14–$171.098
UT$160.031
VA$160.77–$185.282
VI$166.651
VT$158.631
WA$167.87–$184.792
WI$153.531
WV$161.701
WY$162.531

See 57454 in every payment locality

How the 57454 rate is calculated

Each of 57454’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 · 57454

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.27

2.27 RVUs× 1.000 GPCI

Practice expense2.30

2.30 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

4.9700

Conversion factor

$33.4009

Medicare rate

$166.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,492

Code
57454
Physician work
2.27
Practice expense
2.30
Malpractice
0.40

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 57454 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.27× 1.0002.2700
Practice expense2.30× 1.0112.3253
Malpractice0.40× 0.9850.3940
Total RVUs4.9893
Conversion factor× 33.4009

Office rate, Puerto Rico$166.65

Office: (2.27 × 1 + 2.3 × 1.011 + 0.4 × 0.985) × $33.4009 = $166.65

Facility: (2.27 × 1 + 0.89 × 1.011 + 0.4 × 0.985) × $33.4009 = $119.03

Open 57454 in the RVU calculator

Payment rules and modifiers for 57454

The CMS indicators that decide how 57454 is paid alongside other services.

CMS payment indicators · 57454

Cervical colposcopy, biopsy and endocervical curettage

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

57454 without 51 · national office

$166.00

Cervical colposcopy, biopsy and endocervical curettage

57454-51 · Second procedure: 50%

$83.00

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%).

When to use modifier 51

Codes related to 57454

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 57454
CodeHow it relatesOffice range, Puerto Rico
Same family
57452Colposcopy, cervix, no tissue samplingColposcopic cervical examination without the biopsy and curettage combination.$126.21
57455Cervical biopsy, colposcopy-guided biopsyColposcopy with cervical biopsy, without endocervical curettage.$161.74
57456Cervical colposcopy, endocervical curettageColposcopy with endocervical curettage, without cervical biopsy.$151.35
Used instead
57500Cervical biopsy, tissue sampling or lesion excisionCervical biopsy without colposcopic guidance.$152.36
57460Cervical LEEP biopsy, loop biopsy, not cone excisionColposcopic cervical sampling performed with a loop electrode.$310.93

How 57454 has changed in Puerto Rico

57454 · Office / nonfacility

$166.65

Effective 2026-10-01

The base rate is $2.35 higher than on 2025-10-01, moving from $164.30 to $166.65 (1.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $164.30changed to$166.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.33 changed to 2.27
    • Practice expense RVU 2.35 changed to 2.30
    • Malpractice RVU 0.39 changed to 0.40
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $170.09changed to$164.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.38 changed to 2.35

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $167.31changed to$170.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $172.59changed to$167.31

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.37 changed to 0.39
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $172.15changed to$172.59

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $175.92changed to$172.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.35 changed to 2.38
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $173.17changed to$175.92

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.25 changed to 2.35
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $170.40changed to$173.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.01 changed to 2.25
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $160.74changed to$170.40

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.85 changed to 2.01
    • Malpractice RVU 0.27 changed to 0.37
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $155.49changed to$160.74

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.71 changed to 1.85

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $143.22changed to$155.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.73 changed to 1.71
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $129.78changed to$143.22

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.72 changed to 1.73
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $130.46changed to$129.78

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.30 changed to 0.28

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $129.81changed to$130.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $129.60changed to$129.81

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.36 changed to 0.30
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $125.86changed to$129.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.88 changed to 1.72
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $125.86

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$166.65$119.03RVU26D
2026-07-01$166.65$119.03RVU26C
2026-04-01$166.65$119.03RVU26B
2026-01-01$166.65$119.03RVU26A
2025-10-01$164.30$130.10RVU25D
2025-07-01$164.30$130.10RVU25C
2025-04-01$164.30$130.10RVU25B
2025-01-01$164.30$130.10RVU25A
2024-10-01$170.09$133.55RVU24D
2024-07-01$170.09$133.55RVU24C
2024-04-01$170.09$133.55RVU24B
2024-03-09$170.09$133.55RVU24AR
2024-01-01$167.31$131.37RVU24A
2023-10-01$172.59$134.33RVU23D
2023-07-01$172.15$134.19RVU23C
2023-04-01$172.15$134.19RVU23B
2023-01-01$172.15$134.19RVU23A
2022-10-01$175.92$136.85RVU22D
2022-07-01$175.92$136.85RVU22C
2022-04-01$175.92$136.85RVU22B
2022-01-01$175.92$136.85RVU22A
2021-10-01$173.17$137.29RVU21D
2021-07-01$173.17$137.29RVU21C
2021-04-01$173.17$137.29RVU21B
2021-01-01$173.17$137.29RVU21A
2020-10-01$170.40$140.57RVU20D
2020-07-01$170.40$140.57RVU20C
2020-04-01$170.40$140.57RVU20B
2020-01-01$170.40$140.57RVU20A
2019-10-01$160.74$137.52RVU19D
2019-07-01$160.74$137.52RVU19C
2019-04-01$160.74$137.52RVU19B
2019-01-01$160.74$137.52RVU19A
2018-10-01$155.49$138.45RVU18D
2018-07-01$155.49$138.45RVU18C
2018-04-01$155.49$138.45RVU18B
2018-01-01$155.49$138.45RVU18AR1
2017-10-01$143.22$129.09RVU17D
2017-07-01$143.22$129.09RVU17C
2017-04-01$143.22$129.09RVU17B
2017-01-01$143.22$129.09RVU17A
2016-10-01$129.78$117.91RVU16D
2016-07-01$129.78$117.91RVU16C
2016-04-01$129.78$117.91RVU16B
2016-01-01$129.78$117.91RVU16A
2015-10-01$130.46$118.80RVU15D
2015-07-01$130.46$118.80RVU15C
2015-04-01$129.81$118.21RVU15B
2015-01-01$129.81$118.21RVU15A
2014-10-01$129.60$118.20RVU14D
2014-07-01$129.60$118.20RVU14C
2014-04-01$129.60$118.20RVU14B
2014-01-01$129.60$118.20RVU14A
2013-10-01$125.86$113.86RVU13D
2013-07-01$125.86$113.86RVU13C
2013-04-01$125.86$113.86RVU13B
2013-01-01$125.86$113.86RVU13AR

Price 57454 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

57454 billing questions

When should this code be chosen instead of 57455?

Use this code when colposcopy includes both cervical biopsy and endocervical curettage. Code 57455 describes the colposcopic cervical biopsy service without the curettage component.

Can the cervical biopsy and curettage be reported separately?

No. This code accounts for both sampling services when they are performed with colposcopy; do not separately report those same services.

How many cervical biopsies can be reported under this code?

The code includes one or more directed cervical biopsies along with endocervical curettage. Document the biopsy sites and the curettage performed.

Should modifier 50 be added for biopsies from both sides of the cervix?

No. CMS identifies bilateral adjustment as inappropriate for this code; multiple biopsy sites do not make it a bilateral service.

What global-period care is included?

The 0-day global period includes same-day preoperative and postoperative care. CMS also restricts assistant-at-surgery payment and does not permit co-surgeons or team surgery.

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
RVUs for 57454PPRRVU2026_Oct_nonQPP.csv, line 6,492 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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