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Billing code 57260: Combined vaginal repairMedicare rate & RVUs

Combined repair of anterior and posterior vaginal wall prolapse is reported when both compartments are surgically reconstructed during the same operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities11K Medicare services in 2024

Medicare pays $687.39 for 57260 nationally in a facility.

Medicare rate · 57260

Combined vaginal repair

Work RVUs
12.92
Total RVUs
20.58
Global days
090

National rate · 2026

$687.39

Facility setting, before claim adjustments.

See every locality for 57260 →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 57260 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 57260 covers

Code 57260 represents operative reconstruction of both the anterior and posterior vaginal support during one procedure, commonly for coexisting cystocele and rectocele or other anterior and posterior compartment prolapse. A gynecologist or urogynecologist typically performs the repair through the vagina in an operating room. Cystourethroscopy performed as part of the operation is included in this code.

Choose this combined code when the operative report documents repair of both vaginal compartments; use a single-compartment code when only the anterior or posterior wall is repaired. The report should identify the defects and describe the work on each wall. Do not separately report the component anterior and posterior repairs or included cystourethroscopy. Medicare includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced. Modifier 50 is inappropriate; an assistant may be paid, co-surgeon payment requires 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 57260 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

57260 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$633.01
Alaska*Unavailable$882.54
ArizonaUnavailable$671.27
ArkansasUnavailable$626.38
AtlantaUnavailable$706.19
AustinUnavailable$690.63
BakersfieldUnavailable$684.85
Baltimore/Surr. CntysUnavailable$724.86
BeaumontUnavailable$665.74
BrazoriaUnavailable$673.25

57260 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
57260 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 57260 rate is calculated

Each of 57260’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 · 57260

RVUs × geographic indexes × conversion factor

Work12.92

12.92 RVUs× 1.000 GPCI

Practice expense5.49

5.49 RVUs× 1.000 GPCI

Malpractice2.17

2.17 RVUs× 1.000 GPCI

Adjusted RVUs

20.5800

Conversion factor

$33.4009

Medicare rate

$687.39

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

Payment rules and modifiers for 57260

57260 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57260

Combined vaginal repair

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)1Permitted with supporting documentation.
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 · 57260

Combined vaginal repair

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

57260 without 51 · national facility

$687.39

Combined vaginal repair

57260-51 · Second procedure: 50%

$343.70

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

57260 compared with similar codes

Compare codes · National

5 codes, side by side

  • 57260

    Combined vaginal repair12.92 wRVU

    Not priced

  • 57240

    Anterior repair9.83 wRVU

    Not priced

  • 57250

    Posterior repair9.83 wRVU

    Not priced

  • 57265

    Vaginal prolapse repair14.63 wRVU

    Not priced

  • 57267

    Pelvic floor mesh4.76 wRVU

    Not priced

How to choose

57240Anterior repair
Use 57240 for an anterior-only repair, such as correction of a cystocele. Use 57260 when the posterior vaginal compartment is also repaired.
57250Posterior repair
Use 57250 for a posterior-only vaginal repair. Use 57260 when the anterior compartment is repaired during the same operation as well.
57265Vaginal prolapse repair
Both codes describe combined anterior and posterior repair; 57265 also includes enterocele repair. Select it only when the operative documentation supports that additional repair.
57267Pelvic floor mesh
57267 describes separately reportable add-on mesh or prosthesis implantation, not the vaginal wall repair itself.

Codes related to 57260

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

Codes related to 57260
CodeHow it relatesNational office range
Used instead
57240Anterior repairUsed when repair is limited to the anterior vaginal compartment.No office rate
57250Posterior repairUsed when repair is limited to the posterior vaginal compartment.No office rate
Same family
57265Vaginal prolapse repairCombined compartment repair with additional enterocele repair.No office rate
Add-on codes
57267Pelvic floor meshAdd-on for eligible pelvic floor mesh or prosthesis placement during repair.No office rate

57260 billing questions

Should I report 57260 or separate anterior and posterior repair codes?

Report 57260 when both anterior and posterior vaginal compartments are repaired in the same operation. Use a single-compartment code when the operative work is limited to one wall.

Can cystourethroscopy be billed separately?

Cystourethroscopy performed as part of this combined repair is included in 57260.

Is modifier 50 appropriate?

No. Modifier 50 is inappropriate for this combined vaginal repair.

Can 57267 be reported with 57260?

57267 may be reported as an add-on when eligible mesh or other prosthetic material is implanted for the pelvic floor repair. The operative documentation should support the implantation.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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 57260PPRRVU2026_Oct_nonQPP.csv, line 6,457 (RVU26D)

Open CMS sourceHow we calculate rates

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