Billing code 57268: Enterocele repairMedicare rate & RVUs in Guam
Repair of an enterocele through the vagina, reported when the surgeon corrects a bowel-containing peritoneal bulge into the vaginal vault.
CMS doesn’t publish an office rate for 57268 in Guam.
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 57268 covers
An enterocele is a pouch of peritoneum, sometimes containing small bowel, that descends into the vaginal canal or toward the vaginal apex. This service repairs the defect through a vaginal approach, typically during pelvic reconstructive surgery by a gynecologist or urogynecologist. The operative work addresses the enterocele itself; it is distinct from repair of a rectocele, which involves the rectal wall and posterior vaginal wall.
Report 57268 when the documented repair is performed vaginally, not through an abdominal approach. The operative note should identify the enterocele, the vaginal route, and the repair performed. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.
57268 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $461.70 |
How the 57268 rate is calculated
Each of 57268’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 · 57268
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.38Practice expense 5.02Malpractice 1.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57268
57268 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57268
Enterocele repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57268
Enterocele repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57268 without 51 · national facility
$456.59
Enterocele repair
57268-51 · Second procedure: 50%
$228.30
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%).
57268 compared with similar codes
Compare codes
57268 vs 57270 vs 57250 vs 57267: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57270Enterocele repair
- Use 57268 for vaginal repair of an enterocele and 57270 for an abdominal approach to the same type of defect.
- 57250Posterior repair
- 57250 repairs a rectocele involving the rectal and posterior vaginal walls; 57268 repairs an enterocele bulging into the vagina.
- 57267Pelvic floor mesh
- 57268 represents the enterocele repair; 57267 is an add-on for mesh or other prosthesis when that additional work is performed.
57268 billing questions
How is 57268 distinguished from 57270?
Both address an enterocele, but 57268 is the vaginal approach and 57270 is the abdominal approach. The operative report should support the route used.
Can 57268 be reported with a rectocele repair?
It may be reported with a separately documented rectocele repair when both defects are treated. The enterocele and rectocele work should be identifiable in the operative note.
Can mesh placement be reported with 57268?
billing code 57267 is an add-on for mesh or other prosthesis used to repair a pelvic floor defect. Report it with 57268 only when the documented work supports the mesh service.
Should modifier 50 be used for bilateral repair?
No. The CMS bilateral adjustment does not apply to 57268, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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
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