No office rate
Use 57240 for an anterior-only repair, such as correction of a cystocele. Use 57260 when the posterior vaginal compartment is also repaired.
On this page
CMS RVU26D · Effective 2026-10-01
57260 Combined vaginal repair Medicare reimbursement rates in Indiana
Combined repair of anterior and posterior vaginal wall prolapse is reported when both compartments are surgically reconstructed during the same operation. Compare 57260 office and facility rates across CMS payment localities in Indiana.
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 57260 in Indiana?
Indiana 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
$636.75
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Urogynecologic surgery
About 57260: Combined anterior and posterior vaginal repair
Combined repair of anterior and posterior vaginal wall prolapse is reported when both compartments are surgically reconstructed during the same operation.
Code 57260 represents operative reconstruction of both the anterior and posterior vaginal support during one procedure, commonly for coexisting cystocele and rectocele or other anterior and posterior compartment prolapse. A gynecologist or urogynecologist typically performs the repair through the vagina in an operating room. Cystourethroscopy performed as part of the operation is included in this code.
Choose this combined code when the operative report documents repair of both vaginal compartments; use a single-compartment code when only the anterior or posterior wall is repaired. The report should identify the defects and describe the work on each wall. Do not separately report the component anterior and posterior repairs or included cystourethroscopy. Medicare includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced. Modifier 50 is inappropriate; an assistant may be paid, co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57260
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.92 · 63%
- Practice expense (office) RVU5.49 · 27%
- Malpractice RVU2.17 · 11%
11K
Medicare services in 2024 · #1427 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.
57260 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Use 57250 for a posterior-only vaginal repair. Use 57260 when the anterior compartment is repaired during the same operation as well.
No office rate
Both codes describe combined anterior and posterior repair; 57265 also includes enterocele repair. Select it only when the operative documentation supports that additional repair.
No office rate
57267 describes separately reportable add-on mesh or prosthesis implantation, not the vaginal wall repair itself.
Compare 57260 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
Indiana →
Office / nonfacility
Unavailable
Facility
$636.75
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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 57260 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
6,457
- Code
- 57260
- Physician work
- 12.92
- Practice expense
- 5.49
- Malpractice
- 2.17
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.92 | × 1.000 | 12.9200 |
| Practice expense | 5.49 | × 0.927 | 5.0892 |
| Malpractice | 2.17 | × 0.486 | 1.0546 |
| Total RVUs | 19.0639 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$636.75
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.92 | 1 |
| Practice expense | 5.49 | 0.927 |
| Malpractice | 2.17 | 0.486 |
(12.92 × 1 + 5.49 × 0.927 + 2.17 × 0.486) × $33.4009 = $636.75
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.
57260 billing questions
Should I report 57260 or separate anterior and posterior repair codes?
Report 57260 when both anterior and posterior vaginal compartments are repaired in the same operation. Use a single-compartment code when the operative work is limited to one wall.
Can cystourethroscopy be billed separately?
Cystourethroscopy performed as part of this combined repair is included in 57260.
Is modifier 50 appropriate?
No. Modifier 50 is inappropriate for this combined vaginal repair.
Can 57267 be reported with 57260?
57267 may be reported as an add-on when eligible mesh or other prosthetic material is implanted for the pelvic floor repair. The operative documentation should support the implantation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 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.
6,45457230,,Repair of urethral lesion,A,,6.14,3.94,NA,3.94,,1.08,11.16,11.16,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45557240,,Anterior colporrhaphy,A,,9.83,4.88,NA,4.88,,1.61,16.32,16.32,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45657250,,Repair rectum & vagina,A,,9.83,4.85,NA,4.85,,1.65,16.33,16.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45757260,,Cmbn ant pst colprhy,A,,12.92,5.49,NA,5.49,,2.17,20.58,20.58,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45857265,,Cmbn ap colprhy w/ntrcl rpr,A,,14.63,5.89,NA,5.89,,2.48,23.00,23.00,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45957267,,Insert mesh/pelvic flr addon,A,,4.76,1.02,NA,1.02,,0.78,6.56,6.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46057268,,Repair of bowel bulge,A,,7.38,5.02,NA,5.02,,1.27,13.67,13.67,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915