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Billing code 57284: Paravaginal repairMedicare rate & RVUs

Open abdominal repair restores lateral vaginal support when a paravaginal defect contributes to prolapse, with associated cystocele repair included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities54 Medicare services in 2024

Medicare pays $738.16 for 57284 nationally in a facility.

Medicare rate · 57284

Paravaginal repair

Swap in your local Medicare rate.

Work RVUs
13.97
Total RVUs
22.10
Global days
090

National rate · 2026

$738.16

Facility setting, before claim adjustments.

See every locality for 57284 → · 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 57284 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 57284 covers

This operation restores support where the lateral vaginal wall has separated from its pelvic sidewall attachments, a defect that can contribute to anterior vaginal prolapse. A gynecologist or urogynecologist performs the repair through an open abdominal approach, commonly in an operating room as part of pelvic reconstructive surgery. The code includes repair of an associated cystocele when that repair is part of the procedure.

Choose this code when the operative findings and work document correction of a paravaginal defect through an open abdominal route. A vaginal route for the same defect is represented by 57285; a central anterior wall repair without the lateral defect is a different service. This major operation has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery and co-surgeon payment are permitted; team surgery is not. Modifier 50 is inappropriate for this code.

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 57284 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

57284 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$678.83
Alaska*Unavailable$946.88
ArizonaUnavailable$720.46
ArkansasUnavailable$671.61
AtlantaUnavailable$759.11
AustinUnavailable$740.71
BakersfieldUnavailable$733.08
Baltimore/Surr. CntysUnavailable$778.92
BeaumontUnavailable$715.28
BrazoriaUnavailable$722.11

57284 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.

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View every state and territory as a table
57284 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 57284 rate is calculated

Each of 57284’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 · 57284

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.97Practice expense 5.67Malpractice 2.46

22.1000 adjusted RVUs×$33.4009 conversion factor=$738.16

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 57284

57284 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57284

Paravaginal 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)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 57284

Paravaginal 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

57284 without 51 · national facility

$738.16

Paravaginal repair

57284-51 · Second procedure: 50%

$369.08

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

57284 compared with similar codes

Compare codes

57284 vs 57285 vs 57240 vs 57282: national Medicare rates

Swap in your local Medicare rate.

  • 57284
    Paravaginal repair · 13.97 wRVU
    —
  • 57285
    Paravaginal repair · 11.31 wRVU
    —
  • 57240
    Anterior repair · 9.83 wRVU
    —
  • 57282
    Vaginal suspension · 11.34 wRVU
    —

How to choose

57285Paravaginal repair
Both address a paravaginal defect, but 57284 uses an open abdominal route and 57285 uses a vaginal route.
57240Anterior repair
Use 57240 for anterior vaginal wall repair when the documented work is not an open abdominal repair of a lateral paravaginal defect.
57282Vaginal suspension
57282 is an extraperitoneal vaginal suspension for apical support; 57284 repairs lateral vaginal wall support through an open abdominal approach.

Codes related to 57284

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

Codes related to 57284
CodeHow it relatesNational office range
Used instead
57285Paravaginal repairRepairs a paravaginal defect through a vaginal rather than open abdominal approach.No office rate
57240Anterior repairAddresses anterior vaginal wall prolapse without the same open abdominal paravaginal repair.No office rate
57282Vaginal suspensionProvides extraperitoneal vaginal suspension when apical support is the operative target.No office rate
57283Vaginal colpopexyProvides intraperitoneal vaginal suspension when apical support is the operative target.No office rate

57284 billing questions

How does 57284 differ from 57285?

The distinction is the operative route for repairing the paravaginal defect: 57284 is performed through an open abdominal approach, while 57285 uses a vaginal approach.

Can a cystocele repair be separately reported?

Repair of an associated cystocele is included when performed as part of the paravaginal repair. The operative note should clarify whether the work addresses the lateral defect, rather than only a central anterior wall defect.

Should modifier 50 be used for a bilateral defect?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.

What global period applies?

The procedure has a 90-day global period. The day-before preoperative visit and related postoperative care during that period are included.

May an assistant or another surgeon be reported?

Assistant-at-surgery and co-surgeon payment are permitted. Team surgery is not permitted for this code.

How does the multiple-procedure reduction affect payment?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

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 57284PPRRVU2026_Oct_nonQPP.csv, line 6,465 (RVU26D)

Open CMS sourceHow we calculate rates

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