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Billing code 57296: Vaginal graft revisionMedicare rate & RVUs

Reports abdominal revision or removal of previously placed vaginal graft material when the surgeon must address the graft through an open abdominal approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities50 Medicare services in 2024

Medicare pays $843.04 for 57296 nationally in a facility.

Medicare rate · 57296

Vaginal graft revision

Swap in your local Medicare rate.

Work RVUs
16.15
Total RVUs
25.24
Global days
090

National rate · 2026

$843.04

Facility setting, before claim adjustments.

See every locality for 57296 → · 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 57296 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 57296 covers

A surgeon revises or removes previously implanted graft material supporting the vagina, reaching it through an open abdominal incision. The operation may address a problem with an existing graft used in pelvic floor reconstruction. It is distinct from revising graft material through the vagina and from operating on a urethral sling. These cases are generally performed by gynecologic or urogynecologic surgeons in a facility setting.

Select this code when the operative report identifies revision or removal of vaginal graft material and documents the open abdominal route; the approach and the work on the existing graft distinguish it from initial graft placement or repair of a separate pelvic support defect. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate.

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 57296 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

57296 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$775.88
Alaska*Unavailable$1,083.90
ArizonaUnavailable$822.95
ArkansasUnavailable$767.71
AtlantaUnavailable$867.00
AustinUnavailable$845.47
BakersfieldUnavailable$836.40
Baltimore/Surr. CntysUnavailable$889.34
BeaumontUnavailable$817.51
BrazoriaUnavailable$824.68

57296 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
57296 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 57296 rate is calculated

Each of 57296’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 · 57296

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.15Practice expense 6.26Malpractice 2.83

25.2400 adjusted RVUs×$33.4009 conversion factor=$843.04

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

Payment rules and modifiers for 57296

57296 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57296

Vaginal graft revision

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 · 57296

Vaginal graft revision

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

57296 without 51 · national facility

$843.04

Vaginal graft revision

57296-51 · Second procedure: 50%

$421.52

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

57296 compared with similar codes

Compare codes

57296 vs 57295 vs 57287 vs 57284: national Medicare rates

Swap in your local Medicare rate.

  • 57296
    Vaginal graft revision · 16.15 wRVU
    —
  • 57295
    Vaginal graft revision · 7.62 wRVU
    —
  • 57287
    Sling revision · 10.87 wRVU
    —
  • 57284
    Paravaginal repair · 13.97 wRVU
    —

How to choose

57295Vaginal graft revision
Both address revision or removal of vaginal graft material. Choose 57296 for the open abdominal approach and 57295 for the vaginal approach.
57287Sling revision
This code addresses vaginal graft material; 57287 is for revision or removal of a urethral sling. Identify the implant being treated.
57284Paravaginal repair
This code revises or removes existing vaginal graft material. Code 57284 addresses open repair of a paravaginal defect, not graft revision.

Codes related to 57296

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

Codes related to 57296
CodeHow it relatesNational office range
Same family
57295Vaginal graft revisionRevision or removal of vaginal graft material through the vaginal approach.No office rate
Used instead
57287Sling revisionFor revision or removal of a urethral sling rather than vaginal graft material.No office rate
57284Paravaginal repairOpen repair of a paravaginal defect, rather than revision of existing vaginal graft material.No office rate

57296 billing questions

How is this distinguished from 57295?

This code is for revision or removal of vaginal graft material through an open abdominal approach. Code 57295 describes the vaginal approach.

Is this the right code for revising a urethral sling?

No. This code concerns vaginal graft material; code 57287 addresses revision or removal of a sling. The operative report should identify the implanted material and the work performed.

Can the initial graft placement be reported with this code?

This code reports work on previously placed graft material, not its initial placement. Report only services supported as distinct procedures by the operative documentation.

What documentation supports the abdominal approach?

The operative report should identify the existing vaginal graft, the reason for revision or removal, the work performed on it, and the open abdominal route.

Can modifier 50 be used for bilateral work?

No. Modifier 50 is inappropriate for this code.

How are other procedures in the same session handled?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The code has a 90-day global period.

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 57296PPRRVU2026_Oct_nonQPP.csv, line 6,473 (RVU26D)

Open CMS sourceHow we calculate rates

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