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Billing code 57292: Vaginal constructionMedicare rate & RVUs

Reports surgical creation of a vaginal canal using a graft, such as for vaginal agenesis or absence, rather than repair of an existing vagina.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $731.48 for 57292 nationally in a facility.

Medicare rate · 57292

Vaginal construction

Swap in your local Medicare rate.

Work RVUs
13.66
Total RVUs
21.90
Global days
090

National rate · 2026

$731.48

Facility setting, before claim adjustments.

See every locality for 57292 → · 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 57292 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 57292 covers

This operation creates a vaginal canal using graft tissue. A typical indication is congenital vaginal agenesis, including cases where a patient has no functional vaginal canal; it may also be used when the vagina is absent after prior treatment. A gynecologic or reconstructive surgeon generally performs the procedure in an operating room. The operative report should establish that the surgeon constructed the canal and used a graft, rather than repairing or revising an existing vagina.

Choose this code when the construction includes a graft; code 57291 describes construction without a graft. Document the indication, operative approach, graft use, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; 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 57292 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

57292 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$672.41
Alaska*Unavailable$936.47
ArizonaUnavailable$713.93
ArkansasUnavailable$665.21
AtlantaUnavailable$752.02
AustinUnavailable$734.62
BakersfieldUnavailable$727.69
Baltimore/Surr. CntysUnavailable$771.96
BeaumontUnavailable$708.23
BrazoriaUnavailable$715.81

57292 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
57292 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 57292 rate is calculated

Each of 57292’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 · 57292

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.66Practice expense 5.85Malpractice 2.39

21.9000 adjusted RVUs×$33.4009 conversion factor=$731.48

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

Payment rules and modifiers for 57292

57292 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57292

Vaginal construction

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 · 57292

Vaginal construction

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

57292 without 51 · national facility

$731.48

Vaginal construction

57292-51 · Second procedure: 50%

$365.74

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

57292 compared with similar codes

Compare codes

57292 vs 57291 vs 57200 vs 57295 vs 57296: national Medicare rates

Swap in your local Medicare rate.

  • 57292
    Vaginal construction · 13.66 wRVU
    —
  • 57291
    Vaginal construction · 8.42 wRVU
    —
  • 57200
    Vaginal repair · 4.31 wRVU
    —
  • 57295
    Vaginal graft revision · 7.62 wRVU
    —
  • 57296
    Vaginal graft revision · 16.15 wRVU
    —

How to choose

57291Vaginal construction
Both codes describe vaginal construction, but 57292 is selected when the surgeon uses a graft; 57291 is for construction without one.
57200Vaginal repair
57200 describes repair of the vagina. It does not represent creation of a vaginal canal with graft tissue.
57295Vaginal graft revision
57295 addresses revision of a vaginal graft through a vaginal approach, not initial construction of a vagina with a graft.
57296Vaginal graft revision
57296 addresses revision of a vaginal graft through an open abdominal approach; 57292 is for graft-based construction.

Codes related to 57292

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

Codes related to 57292
CodeHow it relatesNational office range
Same family
57291Vaginal constructionVaginal construction without a graft; the key distinction is whether graft tissue is used.No office rate
Used instead
57200Vaginal repairVaginal repair may fit an existing-tissue repair rather than construction of a canal.No office rate
57210Vaginal repairRepair involving the vagina and perineum differs from creating a vaginal canal with a graft.No office rate

57292 billing questions

How do I choose between 57292 and 57291?

Use 57292 when the vaginal canal is constructed with a graft. Use 57291 for construction without a graft.

Is this a repair of an existing vagina?

No. This code describes creating a vaginal canal with a graft. A repair code is considered when the operative service repairs existing vaginal tissue instead.

What documentation supports 57292?

The operative report should describe the need for construction, creation of the canal, and use of graft tissue. It should distinguish the procedure from repair or revision of an existing vagina.

Should modifier 50 be appended?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the descriptor or anatomy.

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

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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 57292PPRRVU2026_Oct_nonQPP.csv, line 6,471 (RVU26D)

Open CMS sourceHow we calculate rates

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