$149.80
Both codes describe vaginal lesion destruction. Choose 57065 for extensive lesions and 57061 for simple lesions, based on the documented extent.
On this page
CMS RVU26D · Effective 2026-10-01
57065 Vaginal lesion destruction Medicare reimbursement rates in Kentucky
Reports destruction of extensive vaginal lesions, such as broad or multiple condylomata or dysplastic lesions, using an ablative treatment approach. Compare 57065 office and facility rates across CMS payment localities in Kentucky.
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 57065 in Kentucky?
Kentucky 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
$224.97
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$157.57
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Gynecologic procedure
About 57065: Extensive vaginal lesion destruction
Reports destruction of extensive vaginal lesions, such as broad or multiple condylomata or dysplastic lesions, using an ablative treatment approach.
CPT 57065 describes destruction of extensive lesions on the vaginal mucosa. A gynecologist typically performs the treatment using an ablative technique for lesions such as vaginal condylomata or dysplastic lesions. The procedure may take place in an office procedure room or operating room, depending on the lesion burden and planned anesthesia. Lesions on the vulva are coded separately from lesions within the vagina.
Choose this code when the documented extent supports the extensive-lesion service rather than the simple-lesion service; the operative note should identify the treated vaginal sites, extent, and treatment performed. This minor procedure has a 10-day global period, so related postoperative visits during that period are included. 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. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 57065
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- 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 RVU2.59 · 36%
- Practice expense (office) RVU4.20 · 58%
- Malpractice RVU0.45 · 6%
2.1K
Medicare services in 2024 · #2412 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.
57065 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$254.46
This is the extensive-lesion destruction code for the vulva. Use 57065 for lesions on the vaginal mucosa.
$170.43
This describes simple destruction of vulvar lesions. It differs from 57065 in both the treated site and the extent represented.
$98.06
This code represents biopsy of vaginal mucosa for tissue sampling; 57065 represents destruction of extensive vaginal lesions.
Compare 57065 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
Kentucky →
Office / nonfacility
$224.97
Facility
$157.57
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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 57065 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,434
- Code
- 57065
- Physician work
- 2.59
- Practice expense
- 4.20
- Malpractice
- 0.45
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.59 | × 1.000 | 2.5900 |
| Practice expense | 4.20 | × 0.889 | 3.7338 |
| Malpractice | 0.45 | × 0.915 | 0.4118 |
| Total RVUs | 6.7355 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$224.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.59 | 1 |
| Practice expense | 4.2 | 0.889 |
| Malpractice | 0.45 | 0.915 |
(2.59 × 1 + 4.2 × 0.889 + 0.45 × 0.915) × $33.4009 = $224.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.59 | 1 |
| Practice expense | 1.93 | 0.889 |
| Malpractice | 0.45 | 0.915 |
(2.59 × 1 + 1.93 × 0.889 + 0.45 × 0.915) × $33.4009 = $157.57
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.
57065 billing questions
How do I choose 57065 instead of 57061?
Use 57065 when the documentation supports extensive vaginal lesions; 57061 is for simple vaginal lesions. Document the treated sites and extent rather than relying on lesion count alone.
Can I append modifier 50 when lesions are on both sides?
No. The CMS bilateral adjustment does not apply to 57065, and modifier 50 is inappropriate.
Are postoperative visits separately billable?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Does 57065 cover lesions on the vulva?
No. This code concerns vaginal lesions; vulvar lesion destruction is represented by the corresponding vulvar code selected for its documented extent.
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.
6,43157022,,I&d vaginal hematoma ob/pp,A,,2.66,1.66,NA,1.66,,0.46,4.78,4.78,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43257023,,I&d vaginal hematoma non-ob,A,,5.05,2.54,NA,2.54,,0.89,8.48,8.48,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43357061,,Destruction vag lesions smpl,A,,1.27,3.39,,1.67,,0.22,4.88,3.16,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43457065,,Destruction vag lesion xtnsv,A,,2.59,4.20,,1.93,,0.45,7.24,4.97,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43557100,,Biopsy vaginal mucosa simple,A,,1.17,1.76,,0.36,,0.22,3.15,1.75,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43657105,,Biopsy vaginal mucosa xtnsv,A,,1.70,3.22,,2.03,,0.33,5.25,4.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,43757106,,Vagnc prtl rmvl vag wall,A,,7.31,6.08,NA,6.08,,1.35,14.74,14.74,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631