No office rate
Use 56620 for a simple partial vulvectomy. Code 56625 represents complete removal by a simple approach.
On this page
CMS RVU26D · Effective 2026-10-01
56625 Vulvectomy Medicare reimbursement rates in Connecticut
Reports complete removal of vulvar tissue by a simple rather than radical approach, without coding a groin lymphadenectomy as part of the service. Compare 56625 office and facility rates across CMS payment localities in Connecticut.
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 56625 in Connecticut?
Connecticut 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
$659.92
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 56625: Complete simple vulvectomy
Reports complete removal of vulvar tissue by a simple rather than radical approach, without coding a groin lymphadenectomy as part of the service.
A complete simple vulvectomy removes the vulva without the wider, deeper tissue resection associated with a radical vulvectomy. Gynecologists and gynecologic oncologists typically perform it in an operating room, often for extensive vulvar disease requiring removal of the full vulvar area rather than a limited excision. The operative report should establish that the excision was complete and describe its extent and depth.
Choose this code when the procedure is complete but simple; a partial excision or radical resection belongs to a different code. A groin lymphadenectomy is not represented by this service and may change code selection. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 56625
- 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 RVU9.44 · 51%
- Practice expense (office) RVU7.18 · 39%
- Malpractice RVU1.98 · 11%
113
Medicare services in 2024 · #4786 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.
56625 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
Use 56630 when the vulvectomy is radical but partial. Code 56625 is complete and simple, not radical.
No office rate
Both represent complete vulvectomy, but 56633 is radical. The documented depth and extent of resection distinguish it from 56625.
No office rate
Use 56640 for radical complete vulvectomy with lymphadenectomy; 56625 describes a complete simple vulvectomy without that nodal service.
Compare 56625 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$659.92
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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 56625 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
6,413
- Code
- 56625
- Physician work
- 9.44
- Practice expense
- 7.18
- Malpractice
- 1.98
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.44 | × 1.020 | 9.6288 |
| Practice expense | 7.18 | × 1.077 | 7.7329 |
| Malpractice | 1.98 | × 1.210 | 2.3958 |
| Total RVUs | 19.7575 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$659.92
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.44 | 1.02 |
| Practice expense | 7.18 | 1.077 |
| Malpractice | 1.98 | 1.21 |
(9.44 × 1.02 + 7.18 × 1.077 + 1.98 × 1.21) × $33.4009 = $659.92
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.
56625 billing questions
How is this code different from a partial simple vulvectomy?
This code represents removal of the complete vulvar area. Use the partial code when the operation removes only part of the vulva.
Does this code include groin lymph node dissection?
No. A groin lymphadenectomy is not represented by this code; the operative extent and nodal procedure affect selection among the radical vulvectomy codes.
Should modifier 50 be reported for bilateral vulvar work?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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 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.
6,41056605,,Biopsy of vulva/perineum,A,,1.07,1.54,,0.29,,0.19,2.80,1.55,0,000,0.00,0.00,0.00,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41156606,,Biopsy of vulva/perineum,A,,0.54,0.54,,0.13,,0.09,1.17,0.76,0,ZZZ,0.00,0.00,0.00,0,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41256620,,Vulvectomy simple partial,A,,7.34,7.52,NA,7.52,,1.51,16.37,16.37,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41356625,,Vulvectomy simple complete,A,,9.44,7.18,NA,7.18,,1.98,18.60,18.60,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41456630,,Vulvectomy radical partial,A,,14.43,9.27,NA,9.27,,3.18,26.88,26.88,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41556631,,Vlvctmy rad prtl uni lymphad,A,,18.52,10.65,NA,10.65,,4.05,33.22,33.22,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41656632,,Vlvctmy rad prtl bi lymphad,A,,21.31,14.09,NA,14.09,,4.64,40.04,40.04,0,090,0.12,0.74,0.14,2,2,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808