FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

57250 Posterior repair Medicare reimbursement rates in Kentucky

Repair of a rectocele through the posterior vaginal wall, with or without perineal repair, typically performed for symptomatic posterior vaginal wall prolapse. Compare 57250 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 57250 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

No supported rate

Facility setting

$522.77

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.

Find 57250 in your payment locality →

Gynecologic surgery

About 57250: Posterior vaginal wall repair for rectocele

Repair of a rectocele through the posterior vaginal wall, with or without perineal repair, typically performed for symptomatic posterior vaginal wall prolapse.

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.

CMS billing rules for 57250

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 RVU9.83 · 60%
  • Practice expense (office) RVU4.85 · 30%
  • Malpractice RVU1.65 · 10%

12.1K

Medicare services in 2024 · #1373 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.

57250 compared with similar codes

Office rates for Kentucky, from the same CMS release.

57240

Anterior repair

Anterior compartment only

No office rate

Choose 57250 for repair of a posterior vaginal wall rectocele; choose 57240 for an anterior vaginal wall defect such as a cystocele.

57260

Combined vaginal repair

Anterior and posterior walls

No office rate

57260 represents combined anterior and posterior vaginal wall repairs. Use 57250 when the documented repair is limited to the posterior defect.

57268

Enterocele repair

Vaginal approach

No office rate

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.

Compare 57250 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

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

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 57250 in Kentucky.

PPRRVU2026_Oct_nonQPP.csv

6,456

Code
57250
Physician work
9.83
Practice expense
4.85
Malpractice
1.65

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 57250 in Kentucky
ComponentRVULocality factorAdjusted
Physician work9.83× 1.0009.8300
Practice expense4.85× 0.8894.3116
Malpractice1.65× 0.9151.5097
Total RVUs15.6514
Conversion factor× 33.4009

Facility rate, Kentucky$522.77

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work9.831
Practice expense4.850.889
Malpractice1.650.915

(9.83 × 1 + 4.85 × 0.889 + 1.65 × 0.915) × $33.4009 = $522.77

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.

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 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 57250PPRRVU2026_Oct_nonQPP.csv, line 6,456 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet