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CPT code 56634: Radical vulvectomy2026 Medicare rate & RVUs

Reports complete radical removal of the vulva with lymphadenectomy on one side, typically for extensive vulvar malignancy requiring regional nodal surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities21 Medicare services in 2024

Medicare pays $1,228.82 for 56634 nationally in a facility.

Medicare rate · 56634

Radical vulvectomy

Work RVUs
20.14
Total RVUs
36.79
Global days
090

National rate · 2026

$1,228.82

Facility setting, before claim adjustments.

See every locality for 56634 →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.

On this page 10 sections
  1. Medicare rate
  2. What 56634 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 56634 covers

This operation removes the vulva by a radical approach and includes inguinofemoral lymphadenectomy on one side. It is generally performed in an operating room by a gynecologic oncologist or other surgeon treating vulvar cancer when the planned resection is complete and regional node surgery is indicated. The code distinguishes this service from complete radical vulvectomy without node dissection and from the bilateral node-dissection version.

Select the code from the operative plan and report: documentation should establish complete radical vulvar resection and which inguinofemoral side was dissected. The lymphadenectomy is included in this service. The 90-day global period includes 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 other procedures are subject to the standard 50% reduction. Report the unilateral service as described; modifier 50 is inappropriate. CMS permits payment for an assistant at surgery and co-surgeons, but not team surgery.

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 56634 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

56634 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,111.21
Alaska*Unavailable$1,521.31
ArizonaUnavailable$1,193.99
ArkansasUnavailable$1,096.86
AtlantaUnavailable$1,268.53
AustinUnavailable$1,235.65
BakersfieldUnavailable$1,219.19
Baltimore/Surr. CntysUnavailable$1,305.71
BeaumontUnavailable$1,181.73
BrazoriaUnavailable$1,196.35

56634 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
56634 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 56634 rate is calculated

Each of 56634’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 · 56634

RVUs × geographic indexes × conversion factor

Work20.14

20.14 RVUs× 1.000 GPCI

Practice expense11.99

11.99 RVUs× 1.000 GPCI

Malpractice4.66

4.66 RVUs× 1.000 GPCI

Adjusted RVUs

36.7900

Conversion factor

$33.4009

Medicare rate

$1,228.82

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

Payment rules and modifiers for 56634

56634 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 56634

Radical vulvectomy

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)2Paid.
Co-surgeons (62)2Permitted.
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 · 56634

Radical vulvectomy

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

56634 without 51 · national facility

$1,228.82

Radical vulvectomy

56634-51 · Second procedure: 50%

$614.41

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

56634 compared with similar codes

Compare codes · National

5 codes, side by side

  • 56634

    Radical vulvectomy20.14 wRVU

    Not priced

  • 56633

    Vulvectomy19.13 wRVU

    Not priced

  • 56637

    Radical vulvectomy24.13 wRVU

    Not priced

  • 56631

    Radical vulvectomy18.52 wRVU

    Not priced

  • 56640

    Radical vulvectomy24.16 wRVU

    Not priced

How to choose

56633Vulvectomy
Use 56633 for complete radical vulvectomy without inguinofemoral lymphadenectomy. The unilateral node dissection is the distinguishing service in 56634.
56637Radical vulvectomy
Use 56637 when the complete radical vulvectomy includes bilateral inguinofemoral lymphadenectomy; 56634 specifies unilateral dissection.
56631Radical vulvectomy
Both include unilateral inguinofemoral lymphadenectomy, but 56631 is for radical partial vulvectomy rather than complete radical vulvectomy.
56640Radical vulvectomy
This code includes pelvic lymphadenectomy with radical vulvectomy. Code 56634 describes unilateral inguinofemoral lymphadenectomy without that pelvic nodal component.

Codes related to 56634

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

Codes related to 56634
CodeHow it relatesNational office range
Same family
56633VulvectomyComplete radical vulvectomy without the unilateral inguinofemoral lymphadenectomy.No office rate
56637Radical vulvectomyComplete radical vulvectomy with bilateral inguinofemoral lymphadenectomy.No office rate
56631Radical vulvectomyRadical partial vulvectomy with unilateral inguinofemoral lymphadenectomy.No office rate
56640Radical vulvectomyRadical vulvectomy with a broader nodal dissection that includes pelvic lymphadenectomy.No office rate
56630VulvectomyRadical partial vulvectomy without the unilateral node dissection.No office rate

56634 billing questions

Should modifier 50 be used when both sides are dissected?

No. This code specifies unilateral lymphadenectomy, and modifier 50 is inappropriate. Use the code for complete radical vulvectomy with bilateral lymphadenectomy when both sides are dissected.

Can the inguinofemoral lymphadenectomy be billed separately?

The unilateral lymphadenectomy is included in this service. Do not separately report that same nodal dissection as an independent procedure.

What documentation supports choosing this code?

The operative report should support a complete radical vulvar resection and identify the unilateral inguinofemoral lymphadenectomy. Document the side and the procedures actually performed.

How does the 90-day global period affect postoperative visits?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the surgical package.

May an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery and for co-surgeons for this code. 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
RVUs for 56634PPRRVU2026_Oct_nonQPP.csv, line 6,418 (RVU26D)

Open CMS sourceHow we calculate rates

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