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CMS RVU26D · Effective 2026-10-01

57410 Pelvic examination Medicare reimbursement rates in Guam

Reports a complete pelvic assessment performed under anesthesia when pain, intolerance, or another barrier prevents an adequate examination while the patient is awake. Compare 57410 office and facility rates across CMS payment localities in Guam.

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 57410 in Guam?

Guam 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

$96.34

1 of 1 localities have a supported rate.

Payment area: Hawaii, Guam

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.

Find 57410 in your payment locality →

Gynecology

About 57410: Pelvic examination under anesthesia

Reports a complete pelvic assessment performed under anesthesia when pain, intolerance, or another barrier prevents an adequate examination while the patient is awake.

A gynecologist performs a systematic pelvic assessment while the patient is anesthetized, evaluating structures such as the vagina, cervix, uterus, and adnexa by inspection and palpation. This may be needed when severe pain, vaginismus, inability to cooperate, or another documented barrier prevents a clinically adequate examination in the office. The service is generally performed in an operating room or procedure setting, sometimes alongside another gynecologic procedure.

Report 57410 when the anesthetized examination is a distinct, medically necessary service, not merely the routine assessment integral to a more extensive procedure. Document why an awake examination was inadequate and the examination performed and findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 57410

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.71 · 59%
  • Practice expense (office) RVU0.88 · 30%
  • Malpractice RVU0.30 · 10%

2K

Medicare services in 2024 · #2456 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.

57410 compared with similar codes

Office rates for Guam, from the same CMS release.

57420

Vaginal colposcopy

Without vaginal biopsy

$143.73

Choose 57420 for vaginal colposcopy using magnified visualization. Choose 57410 for a pelvic assessment under anesthesia when an awake examination cannot be completed.

57421

Colposcopy

Entire vagina with biopsy

$189.31

57421 includes vaginal colposcopy with biopsy. It is not the code for an anesthetized pelvic examination without that colposcopic biopsy service.

57452

Colposcopy

Cervix, no tissue sampling

$131.27

57452 describes colposcopic examination of the cervix. 57410 describes a broader pelvic assessment performed under anesthesia.

Compare 57410 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

Office and facility base rates · shared scale starting at $0

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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 57410 in Hawaii, Guam.

PPRRVU2026_Oct_nonQPP.csv

6,484

Code
57410
Physician work
1.71
Practice expense
0.88
Malpractice
0.30

GPCI2026.csv

46

Locality
Hawaii, Guam
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Facility calculation for 57410 in Hawaii, Guam
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0001.7100
Practice expense0.88× 1.1371.0006
Malpractice0.30× 0.5790.1737
Total RVUs2.8843
Conversion factor× 33.4009

Facility rate, Hawaii, Guam$96.34

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.711
Practice expense0.881.137
Malpractice0.30.579

(1.71 × 1 + 0.88 × 1.137 + 0.3 × 0.579) × $33.4009 = $96.34

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.

57410 billing questions

When is 57410 appropriate instead of an office pelvic examination?

Use it when anesthesia is needed to complete a medically necessary pelvic assessment because an awake examination cannot be adequately performed, such as with severe pain or inability to tolerate the examination. Document the specific barrier.

Can 57410 be reported with another gynecologic procedure performed during the same session?

A preliminary examination that is integral to the more extensive procedure is not a distinct service. Report 57410 when the anesthetized examination is separately necessary and documented, rather than simply part of the operative assessment.

Should modifier 50 be appended?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What does the 0-day global period include?

Same-day preoperative and postoperative care is included. CMS assigns a 0-day global period to 57410.

How does the multiple procedure rule affect 57410?

When it is performed in the same session as other procedures, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can an assistant or co-surgeon be paid for 57410?

Assistant-at-surgery payment is restricted. 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 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.

RVUs for 57410PPRRVU2026_Oct_nonQPP.csv, line 6,484 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet