Billing code 57310: Fistula repairMedicare rate & RVUs in Illinois
Surgical closure of a urethrovaginal fistula through the vagina is reported when the repair is performed by the vaginal route.
CMS doesn’t publish an office rate for 57310 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 57310 covers
This operation closes an abnormal communication between the urethra and vagina, which can allow urine to pass into the vagina and cause persistent leakage. A gynecologic surgeon, urogynecologist, or urologist repairs the tract through vaginal access, reconstructing the tissues between the organs. The procedure is performed in an operative setting and is distinct from repair of a bladder-to-vagina or rectum-to-vagina fistula.
Report 57310 when the operative documentation identifies a urethrovaginal fistula and records a vaginal approach; use 57311 when the repair is performed through an abdominal approach. Documentation should establish the tract’s origin and destination, the surgical route, and the repair performed. The 90-day major-surgery global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate for this descriptor and anatomy. 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.
Where 57310 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 | $493.01 |
| East St. Louis | Unavailable | $468.01 |
| Rest Of Illinois | Unavailable | $452.37 |
| Suburban Chicago | Unavailable | $479.93 |
How the 57310 rate is calculated
Each of 57310’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 · 57310
RVUs × geographic indexes × conversion factor
Work7.46
7.46 RVUs× 1.000 GPCI
Practice expense5.02
5.02 RVUs× 1.000 GPCI
Malpractice0.96
0.96 RVUs× 1.000 GPCI
Adjusted RVUs
13.4400
Conversion factor
$33.4009
Medicare rate
$448.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57310
57310 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57310
Fistula 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 · 57310
Fistula 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
57310 without 51 · national facility
$448.91
Fistula repair
57310-51 · Second procedure: 50%
$224.46
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%).
57310 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57311Fistula repair
- Both codes address urethrovaginal fistula repair. Use 57310 for the vaginal route and 57311 for the abdominal route.
- 57320Fistula repair
- This code is for a bladder-to-vagina fistula repaired vaginally. Code 57310 is for a urethra-to-vagina fistula.
- 57330Fistula repair
- This code addresses a bladder-to-vagina fistula repaired abdominally; 57310 addresses a urethra-to-vagina fistula repaired vaginally.
57310 billing questions
When should 57310 be chosen over 57311?
Choose 57310 when the urethrovaginal fistula is repaired through a vaginal approach. Code 57311 represents repair through an abdominal approach.
Can 57310 be used for a vesicovaginal fistula?
No. This code concerns a tract between the urethra and vagina; codes 57320 or 57330 concern a bladder-to-vagina fistula, depending on approach.
Is modifier 50 appropriate for this repair?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
What does the 90-day global include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports reporting 57310?
The operative record should identify the urethrovaginal tract, document the vaginal approach, and describe the repair performed.
How are multiple procedures handled when performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple-procedure reduction.
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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