Billing code 56810: PerineoplastyMedicare rate & RVUs in Delaware
A nonobstetric perineoplasty reconstructs the perineal body for a documented defect or separation when repair is limited to perineal tissues.
CMS doesn’t publish an office rate for 56810 in Delaware.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 56810 covers
This procedure repairs and reconstructs the perineal body, the tissue between the vaginal opening and anus. Gynecologists, urogynecologists, and other surgeons may perform it for a nonobstetric perineal defect, such as separation or scarring after prior trauma or surgery. The operative target is the perineum, rather than an isolated vaginal-wall injury or the vaginal opening itself; the procedure may be performed in an operating room or another suitable surgical setting.
Report the code when the operative documentation supports nonobstetric repair confined to the perineum. Describe the defect and its cause, the tissues repaired, and the work performed; use a broader or different repair code when vaginal-wall repair or another distinct operative target is involved. CMS assigns 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 50% multiple-procedure reduction. Modifier 50 is inappropriate under the CMS bilateral rule. CMS permits assistant-at-surgery and co-surgeon payment, but not team-surgery payment.
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.
56810 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $238.52 |
How the 56810 rate is calculated
Each of 56810’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 · 56810
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.18Practice expense 2.33Malpractice 0.71
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 56810
56810 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56810
Perineoplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 56810
Perineoplasty
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
56810 without 51 · national facility
$241.15
Perineoplasty
56810-51 · Second procedure: 50%
$120.58
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%).
56810 compared with similar codes
Compare codes
56810 vs 56800 vs 57200 vs 57210 vs 57250: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 56800Introital repair
- 56800 addresses plastic repair of the introitus. Choose 56810 when the operative repair is directed at the perineal body rather than the vaginal opening.
- 57200Vaginal repair
- 57200 is for suture repair of a nonobstetric vaginal injury. Choose 56810 for a perineal defect without that vaginal-wall injury repair.
- 57210Vaginal repair
- 57210 describes combined vaginal and perineal repair. Choose 56810 when the documented work is confined to the perineum.
- 57250Posterior repair
- 57250 addresses posterior vaginal wall repair for rectocele, sometimes with perineorrhaphy. It is not a substitute for isolated nonobstetric perineal-body repair.
56810 billing questions
How do I distinguish this from repair of a vaginal injury?
Use this code for repair focused on the perineal body. A repair directed at an injury of the vaginal wall is a different service, such as the nonobstetric vaginal-injury repair represented by 57200.
Is repair of the vaginal opening included?
The defining target is the perineum, not an isolated plastic repair of the introitus. If the operative work addresses both distinct areas, review the procedure details and applicable coding guidance before reporting separate services.
Are routine postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
Can modifier 50 be used for a bilateral repair?
No. CMS identifies bilateral adjustment as inapplicable to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and for co-surgeons under this code. Team-surgery payment is 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 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
Fee sheets
Put 56810 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →