$107.46–$117.41
57100 is for simple vaginal mucosa biopsy. Choose 57130 when the procedure removes a vaginal septum rather than taking a diagnostic tissue sample.
On this page
CMS RVU26D · Effective 2026-10-01
57130 Vaginal surgery Medicare reimbursement rates in Massachusetts
Reports surgical removal of a vaginal septum, such as a congenital partition causing menstrual obstruction, difficulty with intercourse, or other symptoms. Compare 57130 office and facility rates across CMS payment localities in Massachusetts.
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 57130 in Massachusetts?
Massachusetts 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
$227.33–$248.68
2 of 2 localities have a supported rate.
Facility setting
$155.58–$167.32
2 of 2 localities have a supported rate.
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 surgery
About 57130: Vaginal septum excision
Reports surgical removal of a vaginal septum, such as a congenital partition causing menstrual obstruction, difficulty with intercourse, or other symptoms.
A gynecologist excises a tissue partition within the vagina, most often a congenital longitudinal or transverse septum. The procedure may address symptoms such as obstructed menstrual flow, difficulty using tampons, or pain with intercourse. It is generally performed in a surgical setting, with the operative approach guided by the septum’s location and extent.
Report 57130 when the operative service is excision of the septum itself, rather than sampling vaginal mucosa or removing a cyst or tumor. Documentation should identify the septum, its location and extent, the reason for removal, and the work performed. The code has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57130
- 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
- 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 RVU2.40 · 36%
- Practice expense (office) RVU3.83 · 58%
- Malpractice RVU0.42 · 6%
36
Medicare services in 2024 · #5556 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.
57130 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$179.73–$197.34
57105 describes an extensive vaginal mucosa biopsy; it does not represent excision of a vaginal septum.
$248.86–$272.22
57135 is used for excision of a vaginal cyst or tumor. 57130 applies when the operative target is a septum.
No office rate
57106 describes partial vaginal-wall removal. 57130 is for septum excision, not resection of a portion of the vaginal wall.
Compare 57130 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
Metropolitan Boston →
Office / nonfacility
$248.68
Facility
$167.32
Rest Of Massachusetts →
Office / nonfacility
$227.33
Facility
$155.58
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57130 billing questions
How is septum excision different from vaginal mucosa biopsy?
Report 57130 for removal of a vaginal septum. Codes 57100 and 57105 describe mucosal sampling, not excision of the partition.
When would 57135 be more appropriate?
Use 57135 when the target is a vaginal cyst or tumor rather than a septum. The operative note should make clear what tissue or lesion was removed.
Can modifier 50 be used for a septum involving both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
Are postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the code’s global period.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is 57130 affected when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
6,44057110,,Vagnc compl rmvl vag wall,A,,15.09,6.25,NA,6.25,,2.55,23.89,23.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44157111,,Vagnc compl rmvl paravag tis,A,,27.69,14.54,NA,14.54,,6.42,48.65,48.65,0,090,0.12,0.74,0.14,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44257120,,Colpocleisis le fort type,A,,8.07,4.78,NA,4.78,,1.33,14.18,14.18,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44357130,,Excision vaginal septum,A,,2.40,3.83,,1.79,,0.42,6.65,4.61,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44457135,,Excision vaginal cyst/tumor,A,,2.63,4.19,,1.95,,0.46,7.28,5.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44557150,,Treat vagina infection,A,,0.49,1.03,,0.11,,0.07,1.59,0.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44657155,,Insert uteri tandem/ovoids,A,,5.02,6.42,,1.66,,0.46,11.90,7.14,0,000,0.00,0.00,0.00,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00