Billing code 57250: Posterior repairMedicare rate & RVUs in Illinois
Repair of a rectocele through the posterior vaginal wall, with or without perineal repair, typically performed for symptomatic posterior vaginal wall prolapse.
CMS doesn’t publish an office rate for 57250 in Illinois.
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 57250 covers
This operation repairs a posterior vaginal wall defect associated with a rectocele, in which the rectum bulges toward the vagina. A gynecologist or urogynecologist typically performs the repair in an operating room for patients with symptoms such as vaginal pressure, a bulge, or difficulty emptying the bowel. The vaginal tissue is opened and the supporting tissue is repaired; perineal repair may also be part of the procedure.
Report 57250 when the operative work addresses the posterior vaginal wall rectocele, and document the defect and the repair performed. Perineorrhaphy may be included when performed with this repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this repair. An assistant at surgery may be paid; 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.
Where 57250 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $619.91 |
| East St. Louis | Unavailable | $588.36 |
| Rest Of Illinois | Unavailable | $562.37 |
| Suburban Chicago | Unavailable | $594.65 |
How the 57250 rate is calculated
Each of 57250’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 · 57250
RVUs × geographic indexes × conversion factor
Work9.83
9.83 RVUs× 1.000 GPCI
Practice expense4.85
4.85 RVUs× 1.000 GPCI
Malpractice1.65
1.65 RVUs× 1.000 GPCI
Adjusted RVUs
16.3300
Conversion factor
$33.4009
Medicare rate
$545.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57250
57250 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57250
Posterior 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 · 57250
Posterior 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
57250 without 51 · national facility
$545.44
Posterior repair
57250-51 · Second procedure: 50%
$272.72
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%).
57250 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57240Anterior repair
- Choose 57250 for repair of a posterior vaginal wall rectocele; choose 57240 for an anterior vaginal wall defect such as a cystocele.
- 57260Combined vaginal repair
- 57260 represents combined anterior and posterior vaginal wall repairs. Use 57250 when the documented repair is limited to the posterior defect.
- 57268Enterocele repair
- 57268 is for vaginal repair of an enterocele, not the posterior vaginal wall rectocele repair represented by 57250. The codes may describe separate defects treated in one operation.
57250 billing questions
How does 57250 differ from 57240?
57250 addresses a posterior vaginal wall rectocele. 57240 addresses an anterior vaginal wall defect, such as a cystocele.
Is perineorrhaphy separately reported with 57250?
Perineorrhaphy may be included when performed as part of the posterior repair. The operative note should describe the work actually performed.
When is 57260 more appropriate?
Use 57260 when the surgeon repairs both anterior and posterior vaginal wall defects during the same operation, rather than reporting only the posterior repair represented by 57250.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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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