Billing code 57285: Paravaginal repairMedicare rate & RVUs in Alaska

Reports vaginal reconstruction of a lateral vaginal support defect, commonly performed for prolapse caused by detachment of the vaginal wall from its pelvic support.

CMS RVU26DEffective Oct 1, 20261 payment locality815 Medicare services in 2024

CMS doesn’t publish an office rate for 57285 in Alaska.

—Office (non-facility)
$786.59Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 57285 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 57285 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 57285 covers

A urogynecologist, gynecologist, or pelvic reconstructive surgeon uses a vaginal route to restore support where the lateral vaginal wall has separated from its pelvic attachment. The repair may address an associated cystocele when that correction is part of the same operation. It is typically performed in a facility operating room for vaginal prolapse caused by a paravaginal defect.

Choose this code when the operative report documents repair of the lateral support defect through the vagina, rather than a central anterior wall repair or an abdominal approach. The note should identify the defect, route, and repair performed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons 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.

57285 in Alaska*

57285 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*Unavailable$786.59

How the 57285 rate is calculated

Each of 57285’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 · 57285

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.31Practice expense 5.20Malpractice 1.90

18.4100 adjusted RVUs×$33.4009 conversion factor=$614.91

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

Payment rules and modifiers for 57285

57285 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 57285

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 · 57285

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

57285 without 51 · national facility

$614.91

Paravaginal repair

57285-51 · Second procedure: 50%

$307.46

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

57285 compared with similar codes

Compare codes

57285 vs 57284 vs 57240 vs 57260: national Medicare rates

Swap in your local Medicare rate.

  • 57285
    Paravaginal repair · 11.31 wRVU
    —
  • 57284
    Paravaginal repair · 13.97 wRVU
    —
  • 57240
    Anterior repair · 9.83 wRVU
    —
  • 57260
    Combined vaginal repair · 12.92 wRVU
    —

How to choose

57284Paravaginal repair
Use 57285 for the vaginal route to a paravaginal defect; 57284 describes the open abdominal route.
57240Anterior repair
57240 addresses anterior vaginal wall repair, typically a central defect. This code is for restoring lateral vaginal support; a cystocele repaired as part of that work is included.
57260Combined vaginal repair
57260 combines anterior and posterior vaginal wall repairs. It is not the specific choice for a lateral paravaginal defect repaired vaginally.

57285 billing questions

How does this differ from 57284?

Both address a paravaginal support defect, but 57285 uses a vaginal route. Code 57284 is the open abdominal approach.

Can 57240 also be reported for a cystocele?

A cystocele corrected as part of the paravaginal repair is included in this service. Do not separately report 57240 for the same repair work; document any distinct, separately performed anterior wall repair clearly.

Can mesh insertion be reported with this repair?

When qualifying mesh or another prosthesis is inserted for the pelvic floor defect, 57267 is the related add-on code. The operative note should support the insertion and site.

Should modifier 50 be used for bilateral repair?

No. The code's anatomy and descriptor make modifier 50 inappropriate.

How are assistant and co-surgeon services treated?

CMS permits payment for an assistant at surgery and for co-surgeons. Team surgery is not permitted for this code.

What postoperative care is included?

The 90-day global period includes the preoperative visit on the day before surgery and 90 days of related postoperative care.

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 57285PPRRVU2026_Oct_nonQPP.csv, line 6,466 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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