No office rate
57300 describes rectovaginal fistula closure by vaginal approach without the colostomy included in 57307. Choose 57307 when repair and colostomy are performed together.
On this page
CMS RVU26D · Effective 2026-10-01
57307 Fistula repair Medicare reimbursement rates in Alabama
Reports closure of a rectovaginal fistula with colostomy, combining repair of the abnormal connection and fecal diversion in one operative service. Compare 57307 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 57307 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$918.58
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gynecologic surgery
About 57307: Rectovaginal fistula repair with colostomy
Reports closure of a rectovaginal fistula with colostomy, combining repair of the abnormal connection and fecal diversion in one operative service.
This operation closes an abnormal connection between the rectum and vagina and includes creation of a colostomy to divert stool. The repair may use a vaginal or abdominal approach. It is performed in an operating room, typically by a surgeon experienced in pelvic or colorectal surgery, for patients whose fistula requires operative closure with diversion.
Report 57307 for the combined repair and colostomy, rather than treating the included diversion as a separate colostomy service. The operative report should identify the fistula, describe the repair and approach, and document the colostomy. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. 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% multiple-procedure reduction. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 57307
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.74 · 56%
- Practice expense (office) RVU10.74 · 36%
- Malpractice RVU2.41 · 8%
25
Medicare services in 2024 · #5797 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.
57307 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
57305 describes rectovaginal fistula closure by abdominal approach without the colostomy included in 57307. The colostomy is the key distinction for 57307.
No office rate
57308 identifies a transperineal approach to rectovaginal fistula closure. 57307 is distinguished by the colostomy performed with the repair.
Compare 57307 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$918.58
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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 57307 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,476
- Code
- 57307
- Physician work
- 16.74
- Practice expense
- 10.74
- Malpractice
- 2.41
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.74 | × 1.000 | 16.7400 |
| Practice expense | 10.74 | × 0.875 | 9.3975 |
| Malpractice | 2.41 | × 0.566 | 1.3641 |
| Total RVUs | 27.5016 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$918.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.74 | 1 |
| Practice expense | 10.74 | 0.875 |
| Malpractice | 2.41 | 0.566 |
(16.74 × 1 + 10.74 × 0.875 + 2.41 × 0.566) × $33.4009 = $918.58
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.
57307 billing questions
When should 57307 be selected instead of 57300 or 57305?
Use 57307 when the rectovaginal fistula repair is performed with a colostomy. Codes 57300 and 57305 describe repair without the colostomy included in 57307.
Can the colostomy be billed separately with 57307?
The colostomy is part of the combined service represented by 57307. Do not separately report a colostomy code for that included work.
What documentation supports reporting 57307?
Document the rectovaginal fistula, the closure performed, the operative approach, and creation of the colostomy.
Does modifier 50 apply to this repair?
No. Modifier 50 is not appropriate for this single fistula repair with colostomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for the repair and colostomy.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard 50% multiple-procedure 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 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.
6,47357296,,Revise vag graft open abd,A,,16.15,6.26,NA,6.26,,2.83,25.24,25.24,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47457300,,Repair rectum-vagina fistula,A,,8.49,6.79,NA,6.79,,1.61,16.89,16.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47557305,,Repair rectum-vagina fistula,A,,14.97,8.98,NA,8.98,,2.97,26.92,26.92,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47657307,,Fistula repair & colostomy,A,,16.74,10.74,NA,10.74,,2.41,29.89,29.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47757308,,Fistula repair transperine,A,,10.33,7.07,NA,7.07,,1.48,18.88,18.88,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47857310,,Repair urethrovaginal lesion,A,,7.46,5.02,NA,5.02,,0.96,13.44,13.44,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47957311,,Repair urethrovaginal lesion,A,,8.69,5.28,NA,5.28,,1.12,15.09,15.09,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515