No office rate
56441 separates labial adhesions; 56442 is for a procedure involving the hymen. Identify the tissue being treated.
On this page
CMS RVU26D · Effective 2026-10-01
56441 Labial adhesion lysis Medicare reimbursement rates in Michigan
Reports procedural separation of fused labial tissue, commonly for symptomatic labial adhesions when a clinician performs lysis in an office or procedure setting. Compare 56441 office and facility rates across CMS payment localities in Michigan.
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 56441 in Michigan?
Michigan 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
$174.68–$186.48
2 of 2 localities have a supported rate.
Facility setting
$136.56–$146.19
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 procedure
About 56441: Lysis of labial adhesions
Reports procedural separation of fused labial tissue, commonly for symptomatic labial adhesions when a clinician performs lysis in an office or procedure setting.
This service involves separating adhesions that join the labia, typically the labia minora. It is often performed for a child with symptomatic fusion, such as urine trapping, spraying, or local discomfort. A pediatric or general gynecologist, or another qualified clinician, may perform the procedure in an office or procedure setting; the technique and need for anesthesia depend on the patient and extent of the adhesion.
Report 56441 when the clinician actually performs lysis, not merely evaluates the adhesions or recommends conservative treatment. The note should identify the adhesion, clinical indication, and procedure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one 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. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 56441
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.97 · 36%
- Practice expense (office) RVU3.15 · 58%
- Malpractice RVU0.34 · 6%
653
Medicare services in 2024 · #3324 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.
56441 compared with similar codes
Office rates for Michigan, from the same CMS release.
$139.35–$148.81
56441 treats fused labial tissue. 56405 is for incision and drainage of a vulvar or perineal abscess.
$172.00–$183.08
56441 is lysis of labial adhesions; 56420 is incision and drainage of a Bartholin gland abscess.
No office rate
56441 separates labial adhesions. 56440 addresses a Bartholin gland cyst with marsupialization, a different condition and procedure.
Compare 56441 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
Detroit →
Office / nonfacility
$186.48
Facility
$146.19
Rest Of Michigan →
Office / nonfacility
$174.68
Facility
$136.56
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56441 billing questions
When should 56441 be selected instead of 56442?
Use 56441 for separating labial adhesions. Code 56442 describes a procedure involving the hymen, not fused labial tissue.
Does the 10-day global period include follow-up visits?
Related postoperative visits during the 10-day global period are included in 56441.
Can modifier 50 be used for adhesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
How does a same-session procedure affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
What documentation supports reporting 56441?
Document the labial adhesion, why procedural separation was indicated, and the lysis performed. An evaluation or treatment recommendation without lysis does not support this procedure code.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
6,40356405,,I&d vulva/perineal abscess,A,,1.45,2.66,,1.79,,0.26,4.37,3.50,0,010,0.10,0.80,0.10,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40456420,,I&d bartholins gland abscess,A,,1.40,3.81,,1.36,,0.24,5.45,3.00,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40556440,,Mrsplzatn brthlns glnd cst,A,,2.82,1.60,NA,1.60,,0.48,4.90,4.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40656441,,Lysis of labial adhesions,A,,1.97,3.15,,1.90,,0.34,5.46,4.21,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40756442,,Hymenotomy,A,,0.66,0.53,NA,0.53,,0.12,1.31,1.31,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40856501,,Destroy vulva lesions sim,A,,1.54,3.75,,1.80,,0.25,5.54,3.59,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40956515,,Destroy vulva lesion/s compl,A,,3.00,4.67,,2.18,,0.51,8.18,5.69,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00