No office rate
Both address a paravaginal defect, but 57284 uses an open abdominal route and 57285 uses a vaginal route.
On this page
CMS RVU26D · Effective 2026-10-01
57284 Paravaginal repair Medicare reimbursement rates in Connecticut
Open abdominal repair restores lateral vaginal support when a paravaginal defect contributes to prolapse, with associated cystocele repair included when performed. Compare 57284 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 57284 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
$779.33
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.
Pelvic reconstructive surgery
About 57284: Open abdominal paravaginal defect repair
Open abdominal repair restores lateral vaginal support when a paravaginal defect contributes to prolapse, with associated cystocele repair included when performed.
This operation restores support where the lateral vaginal wall has separated from its pelvic sidewall attachments, a defect that can contribute to anterior vaginal prolapse. A gynecologist or urogynecologist performs the repair through an open abdominal approach, commonly in an operating room as part of pelvic reconstructive surgery. The code includes repair of an associated cystocele when that repair is part of the procedure.
Choose this code when the operative findings and work document correction of a paravaginal defect through an open abdominal route. A vaginal route for the same defect is represented by 57285; a central anterior wall repair without the lateral defect is a different service. This major operation has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery and co-surgeon payment are permitted; team surgery is not. Modifier 50 is inappropriate for this code.
CMS billing rules for 57284
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.97 · 63%
- Practice expense (office) RVU5.67 · 26%
- Malpractice RVU2.46 · 11%
54
Medicare services in 2024 · #5312 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.
57284 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
Use 57240 for anterior vaginal wall repair when the documented work is not an open abdominal repair of a lateral paravaginal defect.
No office rate
57282 is an extraperitoneal vaginal suspension for apical support; 57284 repairs lateral vaginal wall support through an open abdominal approach.
Compare 57284 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
$779.33
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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 57284 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
6,465
- Code
- 57284
- Physician work
- 13.97
- Practice expense
- 5.67
- Malpractice
- 2.46
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.97 | × 1.020 | 14.2494 |
| Practice expense | 5.67 | × 1.077 | 6.1066 |
| Malpractice | 2.46 | × 1.210 | 2.9766 |
| Total RVUs | 23.3326 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$779.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.97 | 1.02 |
| Practice expense | 5.67 | 1.077 |
| Malpractice | 2.46 | 1.21 |
(13.97 × 1.02 + 5.67 × 1.077 + 2.46 × 1.21) × $33.4009 = $779.33
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.
57284 billing questions
How does 57284 differ from 57285?
The distinction is the operative route for repairing the paravaginal defect: 57284 is performed through an open abdominal approach, while 57285 uses a vaginal approach.
Can a cystocele repair be separately reported?
Repair of an associated cystocele is included when performed as part of the paravaginal repair. The operative note should clarify whether the work addresses the lateral defect, rather than only a central anterior wall defect.
Should modifier 50 be used for a bilateral defect?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What global period applies?
The procedure has a 90-day global period. The day-before preoperative visit and related postoperative care during that period are included.
May an assistant or another surgeon be reported?
Assistant-at-surgery and co-surgeon payment are permitted. Team surgery is not permitted for this code.
How does the multiple-procedure reduction affect payment?
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% 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.
6,46257280,,Suspension of vagina,A,,16.30,6.66,NA,6.66,,2.69,25.65,25.65,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46357282,,Colpopexy extraperitoneal,A,,11.34,5.21,NA,5.21,,1.87,18.42,18.42,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46457283,,Colpopexy intraperitoneal,A,,11.37,5.21,NA,5.21,,1.95,18.53,18.53,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46557284,,Repair paravag defect open,A,,13.97,5.67,NA,5.67,,2.46,22.10,22.10,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46657285,,Repair paravag defect vag,A,,11.31,5.20,NA,5.20,,1.90,18.41,18.41,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46757287,,Revise/remove sling repair,A,,10.87,7.17,NA,7.17,,1.72,19.76,19.76,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46857288,,Repair bladder defect,A,,11.83,6.13,NA,6.13,,1.91,19.87,19.87,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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