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CMS RVU26D · Effective 2026-10-01

57100 in Chico

Office / nonfacility

$108.11

Base rate per service

Facility setting

$56.86

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Gynecology procedure

About 57100: Simple vaginal mucosal biopsy

Report this service for a simple biopsy of vaginal mucosa, such as sampling a localized abnormal area for diagnostic evaluation.

A clinician, commonly a gynecologist, takes a limited sample of vaginal mucosa for diagnosis, often from a localized area that appears abnormal on examination. The procedure may be performed in an office or a facility. The tissue is submitted for microscopic evaluation; the biopsy service is distinct from the laboratory’s examination of the specimen when that service is performed.

Choose this code for a simple mucosal biopsy, rather than the more extensive biopsy described by 57105 or an excision such as removal of a vaginal cyst or tumor. Document the sampled site, the reason for biopsy, and the work performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. 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% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 57100

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.17 · 37%
  • Practice expense (office) RVU1.76 · 56%
  • Malpractice RVU0.22 · 7%

4.6K

Medicare services in 2024 · #1937 by national volume

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.

57100 compared with similar codes

Office rates for Chico, from the same CMS release.

57105

Vaginal biopsy

Extensive mucosal sampling

$181.53

57100 represents simple vaginal mucosal sampling. 57105 is for an extensive biopsy, so the documented extent determines the choice.

57135

Vaginal lesion excision

Cyst or tumor

$250.96

57135 describes excision of a vaginal cyst or tumor. Use 57100 when the service is a simple mucosal biopsy rather than removal of the lesion.

57421

Colposcopy

Entire vagina with biopsy

$185.98

57421 is vaginal colposcopy with biopsy when performed. Do not add 57100 for a biopsy included in that colposcopy service.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 57100 is $108.73—$0.62 higher than the $108.11 rate in Chico. Both use the same code, release and participation basis.

57100 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $108.11

  2. $0.62 higher than Chico

  3. El Centro

    $108.15

    $0.04 higher than Chico

  4. Fresno

    $108.11

    The same base rate than Chico

  5. The same base rate than Chico

  6. $6.99 higher than Chico

  7. Madera

    $108.11

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 57100 ranges from $93.36 in Arkansas to $132.09 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Merced

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Modesto

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Napa

    California · 57100

    Office

    $122.75

    Facility

    $61.12

    $14.64 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 57100

    Office

    $114.24

    Facility

    $58.96

    $6.13 higher than Chico for the office setting.

  • Redding

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 57100

    Office

    $110.48

    Facility

    $59.23

    $2.37 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 57100

    Office

    $112.79

    Facility

    $58.41

    $4.68 higher than Chico for the office setting.

  • Salinas

    California · 57100

    Office

    $112.36

    Facility

    $58.17

    $4.25 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 57100

    Office

    $114.54

    Facility

    $58.62

    $6.43 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 57100

    Office

    $129.05

    Facility

    $63.12

    $20.94 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 57100

    Office

    $128.80

    Facility

    $62.87

    $20.69 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 57100

    Office

    $132.09

    Facility

    $64.66

    $23.98 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 57100

    Office

    $131.06

    Facility

    $63.63

    $22.95 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 57100

    Office

    $110.64

    Facility

    $57.38

    $2.53 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 57100

    Office

    $115.26

    Facility

    $58.45

    $7.15 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 57100

    Office

    $112.66

    Facility

    $58.13

    $4.55 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 57100

    Office

    $116.38

    Facility

    $58.96

    $8.27 higher than Chico for the office setting.

  • Stockton

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 57100

    Office

    $122.39

    Facility

    $60.76

    $14.28 higher than Chico for the office setting.

  • Visalia

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 57100

    Office

    $108.11

    Facility

    $56.86

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 57100

    Office

    $118.62

    Facility

    $63.53

    $10.51 higher than Chico for the office setting.

  • Miami

    Florida · 57100

    Office

    $118.86

    Facility

    $70.18

    $10.75 higher than Chico for the office setting.

  • Chicago

    Illinois · 57100

    Office

    $115.30

    Facility

    $68.30

    $7.19 higher than Chico for the office setting.

  • Manhattan

    New York · 57100

    Office

    $121.54

    Facility

    $67.21

    $13.43 higher than Chico for the office setting.

  • Alaska*

    Alaska · 57100

    Office

    $125.27

    Facility

    $75.47

    $17.16 higher than Chico for the office setting.

  • Alabama

    Alabama · 57100

    Office

    $94.68

    Facility

    $53.76

    $13.43 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 57100

    Office

    $93.36

    Facility

    $53.19

    $14.75 lower than Chico for the office setting.

  • Arizona

    Arizona · 57100

    Office

    $102.33

    Facility

    $57.02

    $5.78 lower than Chico for the office setting.

  • Colorado

    Colorado · 57100

    Office

    $107.83

    Facility

    $58.08

    $0.28 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 57100

    Office

    $112.06

    Facility

    $61.70

    $3.95 higher than Chico for the office setting.

  • Delaware

    Delaware · 57100

    Office

    $103.96

    Facility

    $57.76

    $4.15 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 57100

    Office

    $111.91

    Facility

    $64.55

    $3.80 higher than Chico for the office setting.

  • Rest Of Florida

    Florida · 57100

    Office

    $106.32

    Facility

    $61.62

    $1.79 lower than Chico for the office setting.

  • Atlanta

    Georgia · 57100

    Office

    $107.75

    Facility

    $60.24

    $0.36 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 57100

    Office

    $100.27

    Facility

    $58.56

    $7.84 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 57100

    Office

    $110.17

    Facility

    $57.01

    $2.06 higher than Chico for the office setting.

  • Iowa

    Iowa · 57100

    Office

    $95.79

    Facility

    $53.00

    $12.32 lower than Chico for the office setting.

  • Idaho

    Idaho · 57100

    Office

    $96.64

    Facility

    $53.62

    $11.47 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 57100

    Office

    $107.96

    Facility

    $64.94

    $0.15 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 57100

    Office

    $104.24

    Facility

    $61.54

    $3.87 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 57100

    Office

    $112.75

    Facility

    $64.72

    $4.64 higher than Chico for the office setting.

  • Indiana

    Indiana · 57100

    Office

    $97.14

    Facility

    $53.80

    $10.97 lower than Chico for the office setting.

  • Kansas

    Kansas · 57100

    Office

    $95.92

    Facility

    $53.65

    $12.19 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 57100

    Office

    $98.06

    Facility

    $56.49

    $10.05 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 57100

    Office

    $102.74

    Facility

    $58.74

    $5.37 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 57100

    Office

    $98.14

    Facility

    $56.76

    $9.97 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 57100

    Office

    $117.41

    Facility

    $61.58

    $9.30 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 57100

    Office

    $107.46

    Facility

    $58.22

    $0.65 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 57100

    Office

    $111.87

    Facility

    $61.70

    $3.76 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 57100

    Office

    $105.71

    Facility

    $58.38

    $2.40 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 57100

    Office

    $97.73

    Facility

    $54.71

    $10.38 lower than Chico for the office setting.

  • Southern Maine

    Maine · 57100

    Office

    $101.97

    Facility

    $55.63

    $6.14 lower than Chico for the office setting.

  • Detroit

    Michigan · 57100

    Office

    $108.20

    Facility

    $63.07

    $0.09 higher than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 57100

    Office

    $101.05

    Facility

    $58.35

    $7.06 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 57100

    Office

    $101.74

    Facility

    $53.63

    $6.37 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 57100

    Office

    $101.46

    Facility

    $57.55

    $6.65 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 57100

    Office

    $102.41

    Facility

    $57.89

    $5.70 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 57100

    Office

    $96.91

    Facility

    $56.60

    $11.20 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 57100

    Office

    $95.12

    Facility

    $54.86

    $12.99 lower than Chico for the office setting.

  • Montana**

    Montana · 57100

    Office

    $105.20

    Facility

    $58.44

    $2.91 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 57100

    Office

    $98.62

    Facility

    $54.99

    $9.49 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 57100

    Office

    $100.85

    Facility

    $54.09

    $7.26 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 57100

    Office

    $96.12

    Facility

    $52.96

    $11.99 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 57100

    Office

    $106.70

    Facility

    $58.03

    $1.41 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 57100

    Office

    $117.58

    Facility

    $63.34

    $9.47 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 57100

    Office

    $112.90

    Facility

    $61.83

    $4.79 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 57100

    Office

    $101.81

    Facility

    $58.93

    $6.30 lower than Chico for the office setting.

  • Nevada**

    Nevada · 57100

    Office

    $104.04

    Facility

    $57.24

    $4.07 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 57100

    Office

    $125.12

    Facility

    $69.52

    $17.01 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 57100

    Office

    $114.10

    Facility

    $62.90

    $5.99 higher than Chico for the office setting.

  • Queens

    New York · 57100

    Office

    $121.66

    Facility

    $66.39

    $13.55 higher than Chico for the office setting.

  • Rest Of New York

    New York · 57100

    Office

    $100.09

    Facility

    $55.67

    $8.02 lower than Chico for the office setting.

  • Ohio

    Ohio · 57100

    Office

    $100.16

    Facility

    $57.46

    $7.95 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 57100

    Office

    $97.28

    Facility

    $55.53

    $10.83 lower than Chico for the office setting.

  • Portland

    Oregon · 57100

    Office

    $110.48

    Facility

    $58.53

    $2.37 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 57100

    Office

    $102.80

    Facility

    $56.22

    $5.31 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 57100

    Office

    $109.74

    Facility

    $61.07

    $1.63 higher than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 57100

    Office

    $99.99

    Facility

    $57.06

    $8.12 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 57100

    Office

    $105.75

    Facility

    $58.47

    $2.36 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 57100

    Office

    $107.10

    Facility

    $58.80

    $1.01 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 57100

    Office

    $99.64

    Facility

    $56.44

    $8.47 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 57100

    Office

    $100.33

    Facility

    $53.57

    $7.78 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 57100

    Office

    $96.46

    Facility

    $53.96

    $11.65 lower than Chico for the office setting.

  • Austin

    Texas · 57100

    Office

    $107.86

    Facility

    $58.39

    $0.25 lower than Chico for the office setting.

  • Beaumont

    Texas · 57100

    Office

    $99.40

    Facility

    $56.85

    $8.71 lower than Chico for the office setting.

  • Brazoria

    Texas · 57100

    Office

    $103.38

    Facility

    $57.04

    $4.73 lower than Chico for the office setting.

  • Dallas

    Texas · 57100

    Office

    $104.29

    Facility

    $57.71

    $3.82 lower than Chico for the office setting.

  • Fort Worth

    Texas · 57100

    Office

    $103.79

    Facility

    $57.69

    $4.32 lower than Chico for the office setting.

  • Galveston

    Texas · 57100

    Office

    $103.85

    Facility

    $57.42

    $4.26 lower than Chico for the office setting.

  • Houston

    Texas · 57100

    Office

    $107.88

    Facility

    $61.44

    $0.23 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 57100

    Office

    $101.50

    Facility

    $57.13

    $6.61 lower than Chico for the office setting.

  • Utah

    Utah · 57100

    Office

    $100.94

    Facility

    $56.98

    $7.17 lower than Chico for the office setting.

  • Virginia

    Virginia · 57100

    Office

    $102.05

    Facility

    $56.09

    $6.06 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 57100

    Office

    $105.75

    Facility

    $58.47

    $2.36 lower than Chico for the office setting.

  • Vermont

    Vermont · 57100

    Office

    $100.99

    Facility

    $54.70

    $7.12 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 57100

    Office

    $107.08

    Facility

    $57.84

    $1.03 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 57100

    Office

    $119.17

    Facility

    $61.79

    $11.06 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 57100

    Office

    $97.66

    Facility

    $52.86

    $10.45 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 57100

    Office

    $100.68

    Facility

    $60.04

    $7.43 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 57100

    Office

    $103.30

    Facility

    $56.54

    $4.81 lower than Chico for the office setting.

See how rates vary across the country

57100 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$93.36

$125.27

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$125.271
AL$94.681
AR$93.361
AZ$102.331
CA$108.11–$132.0929
CO$107.831
CT$112.061
DC$118.621
DE$103.961
FL$106.32–$118.863
GA$100.27–$107.752
GU$110.171
HI$110.171
IA$95.791
ID$96.641
IL$104.24–$115.304
IN$97.141
KS$95.921
KY$98.061
LA$98.14–$102.742
MA$107.46–$117.412
MD$105.71–$118.623
ME$97.73–$101.972
MI$101.05–$108.202
MN$101.741
MO$96.91–$102.413
MS$95.121
MT$105.201
NC$98.621
ND$100.851
NE$96.121
NH$106.701
NJ$112.90–$117.582
NM$101.811
NV$104.041
NY$100.09–$125.125
OH$100.161
OK$97.281
OR$102.80–$110.482
PA$99.99–$109.742
PR$105.751
RI$107.101
SC$99.641
SD$100.331
TN$96.461
TX$99.40–$107.888
UT$100.941
VA$102.05–$118.622
VI$105.751
VT$100.991
WA$107.08–$119.172
WI$97.661
WV$100.681
WY$103.301

Explore 57100 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 57100 in Chico, the physician’s office rate is $108.11 and the facility-setting rate is $56.86: a difference of $51.25.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 57100 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$118.92

$108.11 × 110% = $118.92

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 57100 in Chico.

PPRRVU2026_Oct_nonQPP.csv

6,435

Code
57100
Physician work
1.17
Practice expense
1.76
Malpractice
0.22

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 57100 in Chico
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0171.1899
Practice expense1.76× 1.0961.9290
Malpractice0.22× 0.5360.1179
Total RVUs3.2368
Conversion factor× 33.4009

Office / nonfacility rate, Chico$108.11

Open 57100 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.171.017
Practice expense1.761.096
Malpractice0.220.536

(1.17 × 1.017 + 1.76 × 1.096 + 0.22 × 0.536) × $33.4009 = $108.11

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.171.017
Practice expense0.361.096
Malpractice0.220.536

(1.17 × 1.017 + 0.36 × 1.096 + 0.22 × 0.536) × $33.4009 = $56.86

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

57100 · Office / nonfacility

$108.11

Effective 2026-10-01

The base rate is $5.02 higher than on 2025-10-01, moving from $103.09 to $108.11 (4.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $103.09changed to$108.11

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.20 changed to 1.17
    • Practice expense RVU 1.70 changed to 1.76
    • Malpractice RVU 0.20 changed to 0.22
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $103.09

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$108.11$56.86RVU26D
2026-07-01$108.11$56.86RVU26C
2026-04-01$108.11$56.86RVU26B
2026-01-01$108.11$56.86RVU26A
2025-10-01$103.09$63.13RVU25D
2025-07-01$103.09$63.13RVU25C
2025-04-01$103.09$63.13RVU25B
2025-01-01$103.09$63.13RVU25A

57100 billing questions

When should 57100 be chosen instead of 57105?

Use 57100 for a simple, limited vaginal mucosal biopsy. Use 57105 when the documented biopsy is extensive.

Can the pathology examination be reported separately?

The biopsy is the tissue-sampling service. When a laboratory performs microscopic examination of the specimen, that pathology service may be reported separately, such as with 88305 when the specimen and service meet that code’s criteria.

Can 57100 be reported with vaginal colposcopy code 57421?

Code 57421 includes vaginal or cervical biopsy when performed as part of the colposcopy service. Do not separately report 57100 for that same biopsy.

Is modifier 50 appropriate for biopsies from both sides of the vagina?

No. CMS identifies bilateral adjustment as inappropriate for 57100; modifier 50 should not be used.

What documentation supports 57100?

Record the vaginal site sampled, the clinical reason for sampling, and that a simple mucosal biopsy was performed. The operative or procedure note should distinguish sampling from a more extensive biopsy or excision.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 57100PPRRVU2026_Oct_nonQPP.csv, line 6,435 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)