Billing code 57105: Vaginal biopsyMedicare rate & RVUs

Medicare pays $175.35 for 57105 nationally in the office and $135.61 in a hospital or facility. Local office rates run $154.84–$224.02.

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

What 57105 covers

An extensive vaginal mucosal biopsy removes tissue from a broad or multifocal abnormal area for histologic evaluation. Gynecologists and gynecologic oncologists may perform it in an office or facility setting when examination identifies suspicious vaginal mucosa, such as persistent lesions or changes concerning for vaginal intraepithelial neoplasia or malignancy. The code reflects the extent of the biopsy service, not simply a stated number of tissue fragments.

Choose 57105 rather than 57100 when the documented biopsy work is extensive. Record the lesion distribution and appearance, sites sampled, and extent of tissue collection. The code has a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50 for bilateral vaginal biopsy. Medicare does not pay an assistant at surgery for this service; 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.

Where 57105 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

57105 rates by state

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

How the 57105 rate is calculated

Each of 57105’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.

Payment rules and modifiers for 57105

57105 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

57105 compared with similar codes

How to choose

57100Vaginal biopsy

Use 57100 for a simple vaginal mucosal biopsy. Use 57105 when the documented sampling is extensive; do not select it solely because multiple fragments were submitted.

57421Colposcopy

57421 describes vaginal colposcopy with biopsy. When the biopsies are part of that colposcopy service, they are included rather than separately reported as 57105.

57135Vaginal lesion excision

57135 is for excision of a vaginal cyst or tumor. 57105 is for extensive sampling of vaginal mucosa, not removal of a cyst or tumor.

56605Vulvar biopsy

56605 applies to biopsy of vulvar or perineal tissue. 57105 applies to vaginal mucosa.

Codes related to 57105

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

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

Open CMS sourceHow we calculate rates