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CMS RVU26D · Effective 2026-10-01

57065 Vaginal lesion destruction Medicare reimbursement rates in Maine

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 Maine.

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 Maine?

Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$224.92–$235.01

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $10.09 per service.

Facility setting

$155.16–$159.88

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $4.72 per service.

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 57065 in your payment locality →

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 Maine, from the same CMS release.

57061

Vaginal lesion destruction

Simple treatment

$151.16–$159.27

Both codes describe vaginal lesion destruction. Choose 57065 for extensive lesions and 57061 for simple lesions, based on the documented extent.

56515

Vulvar lesion destruction

Extensive lesions

$254.30–$265.53

This is the extensive-lesion destruction code for the vulva. Use 57065 for lesions on the vaginal mucosa.

56501

Vulvar lesion destruction

Simple lesions

$171.86–$180.83

This describes simple destruction of vulvar lesions. It differs from 57065 in both the treated site and the extent represented.

57100

Vaginal biopsy

Simple mucosal sampling

$97.73–$101.97

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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 57065PPRRVU2026_Oct_nonQPP.csv, line 6,434 (RVU26D)