No office rate
Choose 51900 when the vesicovaginal fistula is repaired through an abdominal approach; this code is for vaginal-route repair.
On this page
CMS RVU26D · Effective 2026-10-01
57289 Fistula repair Medicare reimbursement rates in Michigan
Repair a communication between the bladder and vagina through a vaginal approach, typically for a vesicovaginal fistula documented at surgery. Compare 57289 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 57289 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
No supported rate
Facility setting
$690.94–$742.59
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 57289: Vesicovaginal fistula repair, vaginal approach
Repair a communication between the bladder and vagina through a vaginal approach, typically for a vesicovaginal fistula documented at surgery.
This code covers vaginal surgical repair of a defect connecting the bladder and vagina, most commonly a vesicovaginal fistula. A gynecologic surgeon, urogynecologist, or urologist may perform the repair in an operating room. The operative report should establish the bladder-vaginal communication and describe the repair performed. This is distinct from repairing an anterior vaginal wall prolapse, which does not itself close a fistula.
Report the code when the documented operation repairs the bladder-vaginal defect through the vaginal route; an abdominal approach is a different service. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57289
- 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 RVU12.48 · 60%
- Practice expense (office) RVU6.28 · 30%
- Malpractice RVU2.19 · 10%
77
Medicare services in 2024 · #5089 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.
57289 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
57240 repairs anterior vaginal wall prolapse. It is not the code for closing a bladder-to-vagina fistula.
No office rate
57200 describes vaginal repair without the bladder-and-vagina repair represented here; use this code when the documented operation repairs the bladder-vaginal defect.
Compare 57289 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
Unavailable
Facility
$742.59
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$690.94
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.
57289 billing questions
When is this code used instead of an anterior colporrhaphy?
Use this code for repair of a bladder-to-vagina communication, such as a vesicovaginal fistula. Anterior colporrhaphy addresses anterior vaginal wall prolapse rather than closing a fistula.
How does the abdominal approach differ?
This code describes vaginal-route repair. The abdominal approach to vesicovaginal fistula closure is reported with 51900.
Does the 90-day global period include postoperative visits?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for a fistula involving both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
6,46657285,,Repair paravag defect vag,A,,11.31,5.20,NA,5.20,,1.90,18.41,18.41,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46757287,,Revise/remove sling repair,A,,10.87,7.17,NA,7.17,,1.72,19.76,19.76,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46857288,,Repair bladder defect,A,,11.83,6.13,NA,6.13,,1.91,19.87,19.87,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46957289,,Repair bladder & vagina,A,,12.48,6.28,NA,6.28,,2.19,20.95,20.95,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47057291,,Construction of vagina,A,,8.42,4.73,NA,4.73,,1.47,14.62,14.62,0,090,0.12,0.74,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47157292,,Construct vagina with graft,A,,13.66,5.85,NA,5.85,,2.39,21.90,21.90,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47257295,,Revise vag graft via vagina,A,,7.62,4.57,NA,4.57,,1.24,13.43,13.43,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00