$150.33
Choose 56420 when the abscess involves the Bartholin gland; choose 56405 for a vulvar or perineal abscess at another site.
On this page
CMS RVU26D · Effective 2026-10-01
56420 Abscess drainage Medicare reimbursement rates in Colorado
Drainage of a Bartholin gland abscess, typically performed for a painful, localized vulvar collection at the gland’s duct opening. Compare 56420 office and facility rates across CMS payment localities in Colorado.
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 56420 in Colorado?
Colorado 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
$188.98
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$101.92
1 of 1 localities have a supported rate.
Payment area: Colorado
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.
Gynecology procedure
About 56420: Bartholin gland abscess drainage
Drainage of a Bartholin gland abscess, typically performed for a painful, localized vulvar collection at the gland’s duct opening.
CPT 56420 describes opening and draining an abscess involving a Bartholin gland, commonly presenting as a tender, one-sided swelling near the vaginal opening. A gynecologist or another physician may perform the procedure in an office, clinic, or facility setting. The service addresses an abscess; a noninfected Bartholin cyst or an abscess elsewhere on the vulva calls for a different procedural choice.
Report the code when the documented procedure drains a Bartholin gland abscess. The note should identify the gland or site and describe the abscess and drainage performed. The procedure has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 56420
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- 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 RVU1.40 · 26%
- Practice expense (office) RVU3.81 · 70%
- Malpractice RVU0.24 · 4%
1.2K
Medicare services in 2024 · #2860 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.
56420 compared with similar codes
Office rates for Colorado, from the same CMS release.
Compare 56420 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
Colorado →
Office / nonfacility
$188.98
Facility
$101.92
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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 56420 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,404
- Code
- 56420
- Physician work
- 1.40
- Practice expense
- 3.81
- Malpractice
- 0.24
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.40 | × 1.012 | 1.4168 |
| Practice expense | 3.81 | × 1.064 | 4.0538 |
| Malpractice | 0.24 | × 0.781 | 0.1874 |
| Total RVUs | 5.6581 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$188.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1.012 |
| Practice expense | 3.81 | 1.064 |
| Malpractice | 0.24 | 0.781 |
(1.4 × 1.012 + 3.81 × 1.064 + 0.24 × 0.781) × $33.4009 = $188.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1.012 |
| Practice expense | 1.36 | 1.064 |
| Malpractice | 0.24 | 0.781 |
(1.4 × 1.012 + 1.36 × 1.064 + 0.24 × 0.781) × $33.4009 = $101.92
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.
56420 billing questions
How do I distinguish 56420 from 56405?
Use 56420 for an abscess of the Bartholin gland. Code 56405 is for incision and drainage of a vulvar or perineal abscess not identified as a Bartholin gland abscess.
How does 56420 differ from 56440?
56420 is for draining a Bartholin gland abscess. 56440 describes marsupialization of a Bartholin gland cyst, a different procedure.
Should modifier 50 be appended for bilateral disease?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.
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.
6,40155970,,Sex transformation m to f,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,YYY,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40255980,,Sex transformation f to m,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,YYY,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40356405,,I&d vulva/perineal abscess,A,,1.45,2.66,,1.79,,0.26,4.37,3.50,0,010,0.10,0.80,0.10,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40456420,,I&d bartholins gland abscess,A,,1.40,3.81,,1.36,,0.24,5.45,3.00,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40556440,,Mrsplzatn brthlns glnd cst,A,,2.82,1.60,NA,1.60,,0.48,4.90,4.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40656441,,Lysis of labial adhesions,A,,1.97,3.15,,1.90,,0.34,5.46,4.21,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40756442,,Hymenotomy,A,,0.66,0.53,NA,0.53,,0.12,1.31,1.31,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899