No office rate
57200 is limited to nonobstetric vaginal injury repair. Choose 57210 when the documented reconstruction also includes the perineal body.
On this page
CMS RVU26D · Effective 2026-10-01
57210 Vaginal repair Medicare reimbursement rates in California
Reports nonobstetric reconstruction when a surgeon repairs vaginal tissue and the perineal body together, rather than treating an isolated vaginal or perineal defect. Compare 57210 office and facility rates across CMS payment localities in California.
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 57210 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$355.55–$419.65
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $64.10 per service.
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.
Where 57210 pays more and less in California
Gynecologic surgery
About 57210: Combined vaginal and perineal repair
Reports nonobstetric reconstruction when a surgeon repairs vaginal tissue and the perineal body together, rather than treating an isolated vaginal or perineal defect.
This service reconstructs a defect involving both vaginal tissue and the perineal body, restoring the tissues at the vaginal opening. Gynecologists and urogynecologists may perform it for nonobstetric separation or laxity when both structures require repair. It is not the routine repair performed as part of delivery. Operative documentation should identify the affected vaginal and perineal tissues and describe the repair performed.
Select this code when the documented operation treats both areas; use a vaginal-only or perineal-only code when only one is repaired. The combined work is reported once, not as separate codes for the same repair. CMS assigns 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 is paid in full and the others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 57210
- 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 RVU5.57 · 52%
- Practice expense (office) RVU4.05 · 38%
- Malpractice RVU1.01 · 10%
562
Medicare services in 2024 · #3454 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.
57210 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
56810 addresses nonobstetric perineal reconstruction alone. Use 57210 when vaginal tissue is repaired along with the perineum.
No office rate
57250 is used for posterior colporrhaphy to repair a rectocele. 57210 describes combined vaginal and perineal repair, not a rectocele-directed procedure.
Compare 57210 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $358.38 |
| Chico | Office Unavailable | Facility $355.55 |
| El Centro | Office Unavailable | Facility $355.72 |
| Fresno | Office Unavailable | Facility $355.55 |
| Hanford-Corcoran | Office Unavailable | Facility $355.55 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $376.10 |
| Madera | Office Unavailable | Facility $355.55 |
| Merced | Office Unavailable | Facility $355.55 |
| Modesto | Office Unavailable | Facility $355.55 |
| Napa | Office Unavailable | Facility $393.19 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $372.16 |
| Redding | Office Unavailable | Facility $355.55 |
| Rest Of California | Office Unavailable | Facility $355.55 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $366.43 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $368.15 |
| Salinas | Office Unavailable | Facility $366.67 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $371.70 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $409.94 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $408.79 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $419.65 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $414.97 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $361.36 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $372.39 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $367.06 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $375.82 |
| Stockton | Office Unavailable | Facility $355.55 |
| Vallejo | Office Unavailable | Facility $391.54 |
| Visalia | Office Unavailable | Facility $355.55 |
| Yuba City | Office Unavailable | Facility $355.55 |
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57210 billing questions
When should I choose 57210 instead of 57200?
Use 57210 when the operative repair involves both vaginal tissue and the perineal body. Code 57200 is for a vaginal injury repair without the combined perineal reconstruction.
Is 57210 used for repair during delivery?
No. This is a nonobstetric repair; it does not describe routine repair performed as part of an obstetric delivery.
Should I report a separate perineoplasty code for the same repair?
Do not separately report the perineal portion of the same combined reconstruction. The operative note should show that both the vagina and perineum were repaired.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this midline repair; report the service once.
What global period and multiple-procedure payment rules apply?
CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%.
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.
6,44957170,,Fitting of diaphragm/cap,A,,0.89,1.13,,0.19,,0.16,2.18,1.24,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45057180,,Treat vaginal bleeding,A,,1.59,3.80,,1.34,,0.27,5.66,3.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45157200,,Repair of vagina,A,,4.31,4.01,NA,4.01,,0.80,9.12,9.12,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45257210,,Repair vagina/perineum,A,,5.57,4.05,NA,4.05,,1.01,10.63,10.63,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45357220,,Revision of urethra,A,,4.73,3.79,NA,3.79,,0.81,9.33,9.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45457230,,Repair of urethral lesion,A,,6.14,3.94,NA,3.94,,1.08,11.16,11.16,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45557240,,Anterior colporrhaphy,A,,9.83,4.88,NA,4.88,,1.61,16.32,16.32,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00