CPT code 56441: Labial adhesion lysis2026 Medicare rate & RVUs in Florida
Reports procedural separation of fused labial tissue, commonly for symptomatic labial adhesions when a clinician performs lysis in an office or procedure setting.
Medicare pays $183.45–$204.05 for 56441 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 56441 covers
This service involves separating adhesions that join the labia, typically the labia minora. It is often performed for a child with symptomatic fusion, such as urine trapping, spraying, or local discomfort. A pediatric or general gynecologist, or another qualified clinician, may perform the procedure in an office or procedure setting; the technique and need for anesthesia depend on the patient and extent of the adhesion.
Report 56441 when the clinician actually performs lysis, not merely evaluates the adhesions or recommends conservative treatment. The note should identify the adhesion, clinical indication, and procedure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
Where 56441 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$183.45 to $204.05
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $192.91 | $150.62 |
| Miami | $204.05 | $160.58 |
| Rest Of Florida | $183.45 | $143.54 |
How the 56441 rate is calculated
Each of 56441’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 · 56441
RVUs × geographic indexes × conversion factor
Work1.97
1.97 RVUs× 1.000 GPCI
Practice expense3.15
3.15 RVUs× 1.000 GPCI
Malpractice0.34
0.34 RVUs× 1.000 GPCI
Adjusted RVUs
5.4600
Conversion factor
$33.4009
Medicare rate
$182.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 56441
56441 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56441
Labial adhesion lysis
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not 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 · 56441
Labial adhesion lysis
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
56441 without 51 · national office
$182.37
Labial adhesion lysis
56441-51 · Second procedure: 50%
$91.19
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%).
56441 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 56442Hymenotomy
- 56441 separates labial adhesions; 56442 is for a procedure involving the hymen. Identify the tissue being treated.
- 56405Abscess drainage
- 56441 treats fused labial tissue. 56405 is for incision and drainage of a vulvar or perineal abscess.
- 56420Abscess drainage
- 56441 is lysis of labial adhesions; 56420 is incision and drainage of a Bartholin gland abscess.
- 56440Cyst marsupialization
- 56441 separates labial adhesions. 56440 addresses a Bartholin gland cyst with marsupialization, a different condition and procedure.
56441 billing questions
When should 56441 be selected instead of 56442?
Use 56441 for separating labial adhesions. Code 56442 describes a procedure involving the hymen, not fused labial tissue.
Does the 10-day global period include follow-up visits?
Related postoperative visits during the 10-day global period are included in 56441.
Can modifier 50 be used for adhesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
How does a same-session procedure 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 multiple-procedure reduction.
What documentation supports reporting 56441?
Document the labial adhesion, why procedural separation was indicated, and the lysis performed. An evaluation or treatment recommendation without lysis does not support this procedure code.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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
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