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CPT code 57520: Cervical cone, non-loop excision2026 Medicare rate & RVUs in Puerto Rico

Reports surgical excision of a cone-shaped portion of the cervix for diagnostic or therapeutic evaluation using a non-loop technique.

CMS RVU26DEffective Oct 1, 2026One payment locality958 Medicare services in 2024

In Puerto Rico, Medicare pays $362.20 for 57520 in the office and $274.40 when it’s performed in a hospital or facility.

$362.20Office (non-facility)
$274.40Hospital or facility
+0.5%vs the national office rate ($360.40)

Check a contract rate as a % of Medicare · 57520 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 57520 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 57520 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 57520 covers

This code describes removal of a cone-shaped section of cervical tissue by a non-loop excisional method, commonly cold-knife conization. A gynecologist may perform it in an operating room when cervical dysplasia, glandular abnormalities, or concern for an occult lesion calls for a larger, oriented specimen that includes the transformation zone and endocervical canal. The tissue is submitted for histopathologic examination to assess the lesion and margins.

Choose this code for a non-loop cone excision, not a loop-electrode excision. The operative report should support the indication, method, tissue removed, and any associated steps. Fulguration, dilation and curettage, and repair may be part of the coded service when performed with the cone. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate for this single cervical excision. Medicare does not pay an assistant at surgery for this code; 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 57520

Across 109 of 109 payment localities, the office rate for 57520 runs from $319.39 in Arkansas to $451.32 in San Benito County, CA. Puerto Rico pays $362.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

57520 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$362.20
  2. Los Angeles, CA · California$393.63+$31.43
  3. Washington, DC area · District of Columbia$406.22+$44.02
  4. Miami, FL · Florida$408.94+$46.74
  5. Chicago, IL · Illinois$396.50+$34.30
  6. Manhattan, NY · New York$416.84+$54.64
  7. Alaska · Alaska$428.52+$66.32

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

Every other payment area

57520 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$323.93$247.95
ArkansasArkansas$319.39$244.79
ArizonaArizona$350.39$266.24
Bakersfield, CACalifornia$371.83$276.65
Chico, CACalifornia$369.64$274.46
El Centro, CACalifornia$369.77$274.59
Fresno, CACalifornia$369.64$274.46
Hanford, CACalifornia$369.64$274.46

57520 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.

$319.39

$428.52

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

View every state and territory as a table
57520 office rate range by state
State / territoryOffice rate rangeLocalities
AK$428.521
AL$323.931
AR$319.391
AZ$350.391
CA$369.64–$451.3229
CO$369.031
CT$384.021
DC$406.221
DE$356.001
FL$364.87–$408.943
GA$343.85–$369.302
GU$376.701
HI$376.701
IA$327.481
ID$330.481
IL$357.85–$396.504
IN$332.231
KS$328.101
KY$335.941
LA$336.28–$352.182
MA$367.79–$401.802
MD$361.97–$406.223
ME$334.42–$348.862
MI$346.39–$371.492
MN$347.621
MO$332.10–$350.853
MS$325.701
MT$360.341
NC$337.471
ND$344.721
NE$328.581
NH$365.301
NJ$386.72–$402.642
NM$349.091
NV$356.191
NY$342.56–$429.395
OH$343.201
OK$333.101
OR$351.76–$377.992
PA$342.54–$376.102
PR$362.201
RI$366.691
SC$341.231
SD$342.871
TN$329.971
TX$340.52–$369.998
UT$345.701
VA$349.24–$406.222
VI$362.201
VT$345.361
WA$366.43–$407.682
WI$333.731
WV$345.561
WY$353.541

See 57520 in every payment locality

How the 57520 rate is calculated

Each of 57520’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 · 57520

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.01

4.01 RVUs× 1.000 GPCI

Practice expense5.99

5.99 RVUs× 1.000 GPCI

Malpractice0.79

0.79 RVUs× 1.000 GPCI

Adjusted RVUs

10.7900

Conversion factor

$33.4009

Medicare rate

$360.40

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

6,503

Code
57520
Physician work
4.01
Practice expense
5.99
Malpractice
0.79

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 57520 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.01× 1.0004.0100
Practice expense5.99× 1.0116.0559
Malpractice0.79× 0.9850.7782
Total RVUs10.8440
Conversion factor× 33.4009

Office rate, Puerto Rico$362.20

Office: (4.01 × 1 + 5.99 × 1.011 + 0.79 × 0.985) × $33.4009 = $362.20

Facility: (4.01 × 1 + 3.39 × 1.011 + 0.79 × 0.985) × $33.4009 = $274.40

Open 57520 in the RVU calculator

Payment rules and modifiers for 57520

57520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57520

Cervical cone, non-loop excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.12/0.74/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 57520

Cervical cone, non-loop excision

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

57520 without 51 · national office

$360.40

Cervical cone, non-loop excision

57520-51 · Second procedure: 50%

$180.20

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 57520

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

Codes related to 57520
CodeHow it relatesOffice range, Puerto Rico
Same family
57522LEEP conization, loop electrode excisionCone excision using a loop electrode rather than a non-loop technique.$302.04
Used instead
57500Cervical biopsy, tissue sampling or lesion excisionCervical biopsy for sampling that does not involve cone excision.$152.36
57510Cervical cautery, noncryo, nonlaser methodCervical cauterization treats selected lesions destructively rather than removing a diagnostic cone specimen.$164.49
57513Cervical laser, laser ablationLaser treatment of the cervix is a different approach from non-loop cone excision.$197.56
Often billed with
57505Cervical sampling, endocervical canalEndocervical curettage may be performed during cervical evaluation; same-session work included in the cone should not be separately reported.$150.00

How 57520 has changed in Puerto Rico

57520 · Office / nonfacility

$362.20

Effective 2026-10-01

The base rate is $17.76 higher than on 2025-10-01, moving from $344.44 to $362.20 (5.2%).

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

    $344.44changed to$362.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.11 changed to 4.01
    • Practice expense RVU 5.82 changed to 5.99
    • Malpractice RVU 0.69 changed to 0.79
    • 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

    $357.80changed to$344.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.91 changed to 5.82
    • Malpractice RVU 0.70 changed to 0.69

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $351.96changed to$357.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $362.47changed to$351.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.88 changed to 5.91
    • Malpractice RVU 0.67 changed to 0.70
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $361.24changed to$362.47

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

  6. January 1, 2023

    RVU23A

    $368.47changed to$361.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.84 changed to 5.88
    • Malpractice RVU 0.66 changed to 0.67
    • 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

    $360.28changed to$368.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.54 changed to 5.84
    • Malpractice RVU 0.64 changed to 0.66

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $347.23changed to$360.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.85 changed to 5.54
    • Malpractice RVU 0.63 changed to 0.64
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $331.02changed to$347.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.45 changed to 4.85
    • Malpractice RVU 0.60 changed to 0.63
    • 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

    $315.80changed to$331.02

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.05 changed to 4.45
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $285.44changed to$315.80

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.04 changed to 4.05
    • Malpractice RVU 0.60 changed to 0.59
    • 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

    $254.57changed to$285.44

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.01 changed to 4.04
    • Malpractice RVU 0.59 changed to 0.60
    • 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

    $255.19changed to$254.57

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.99 changed to 4.01
    • Malpractice RVU 0.61 changed to 0.59

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $253.92changed to$255.19

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $252.45changed to$253.92

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.65 changed to 0.61
    • 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

    $246.40changed to$252.45

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.37 changed to 3.99
    • Malpractice RVU 0.68 changed to 0.65
    • 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: $246.40

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$362.20$274.40RVU26D
2026-07-01$362.20$274.40RVU26C
2026-04-01$362.20$274.40RVU26B
2026-01-01$362.20$274.40RVU26A
2025-10-01$344.44$291.34RVU25D
2025-07-01$344.44$291.34RVU25C
2025-04-01$344.44$291.34RVU25B
2025-01-01$344.44$291.34RVU25A
2024-10-01$357.80$300.14RVU24D
2024-07-01$357.80$300.14RVU24C
2024-04-01$357.80$300.14RVU24B
2024-03-09$357.80$300.14RVU24AR
2024-01-01$351.96$295.25RVU24A
2023-10-01$362.47$303.03RVU23D
2023-07-01$361.24$302.27RVU23C
2023-04-01$361.24$302.27RVU23B
2023-01-01$361.24$302.27RVU23A
2022-10-01$368.47$306.03RVU22D
2022-07-01$368.47$306.03RVU22C
2022-04-01$368.47$306.03RVU22B
2022-01-01$368.47$306.03RVU22A
2021-10-01$360.28$301.90RVU21D
2021-07-01$360.28$301.90RVU21C
2021-04-01$360.28$301.90RVU21B
2021-01-01$360.28$301.90RVU21A
2020-10-01$347.23$297.75RVU20D
2020-07-01$347.23$297.75RVU20C
2020-04-01$347.23$297.75RVU20B
2020-01-01$347.23$297.75RVU20A
2019-10-01$331.02$289.65RVU19D
2019-07-01$331.02$289.65RVU19C
2019-04-01$331.02$289.65RVU19B
2019-01-01$331.02$289.65RVU19A
2018-10-01$315.80$282.82RVU18D
2018-07-01$315.80$282.82RVU18C
2018-04-01$315.80$282.82RVU18B
2018-01-01$315.80$282.82RVU18AR1
2017-10-01$285.44$258.40RVU17D
2017-07-01$285.44$258.40RVU17C
2017-04-01$285.44$258.40RVU17B
2017-01-01$285.44$258.40RVU17A
2016-10-01$254.57$232.35RVU16D
2016-07-01$254.57$232.35RVU16C
2016-04-01$254.57$232.35RVU16B
2016-01-01$254.57$232.35RVU16A
2015-10-01$255.19$233.15RVU15D
2015-07-01$255.19$233.15RVU15C
2015-04-01$253.92$231.99RVU15B
2015-01-01$253.92$231.99RVU15A
2014-10-01$252.45$230.88RVU14D
2014-07-01$252.45$230.88RVU14C
2014-04-01$252.45$230.88RVU14B
2014-01-01$252.45$230.88RVU14A
2013-10-01$246.40$224.03RVU13D
2013-07-01$246.40$224.03RVU13C
2013-04-01$246.40$224.03RVU13B
2013-01-01$246.40$224.03RVU13AR

Price 57520 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

57520 billing questions

How does this differ from 57522?

Use 57520 for a non-loop cone excision, commonly performed with a cold knife. Code 57522 describes cone excision using a loop electrode.

Can endocervical curettage be billed separately?

Curettage performed as part of the cone service is included in the code’s scope. Do not separately report the same-session curettage as a distinct service merely because it is documented.

When is 57500 more appropriate?

Code 57500 describes a cervical biopsy rather than removal of a cone-shaped section. Choose 57520 when the surgeon performs the larger excisional cone.

What documentation supports 57520?

Document the clinical indication, non-loop excision method, tissue removed, and operative steps. The record should make clear that the service was a cone excision rather than a limited biopsy or loop procedure.

Does the procedure have a global period?

Yes. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and 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
RVUs for 57520PPRRVU2026_Oct_nonQPP.csv, line 6,503 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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