No office rate
Both codes describe vaginal construction, but 57292 is selected when the surgeon uses a graft; 57291 is for construction without one.
On this page
CMS RVU26D · Effective 2026-10-01
57292 Vaginal construction Medicare reimbursement rates in Minnesota
Reports surgical creation of a vaginal canal using a graft, such as for vaginal agenesis or absence, rather than repair of an existing vagina. Compare 57292 office and facility rates across CMS payment localities in Minnesota.
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 57292 in Minnesota?
Minnesota 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
$680.95
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Gynecologic surgery
About 57292: Vaginal construction using a graft
Reports surgical creation of a vaginal canal using a graft, such as for vaginal agenesis or absence, rather than repair of an existing vagina.
This operation creates a vaginal canal using graft tissue. A typical indication is congenital vaginal agenesis, including cases where a patient has no functional vaginal canal; it may also be used when the vagina is absent after prior treatment. A gynecologic or reconstructive surgeon generally performs the procedure in an operating room. The operative report should establish that the surgeon constructed the canal and used a graft, rather than repairing or revising an existing vagina.
Choose this code when the construction includes a graft; code 57291 describes construction without a graft. Document the indication, operative approach, graft use, and work performed. Medicare 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 code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57292
- 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 RVU13.66 · 62%
- Practice expense (office) RVU5.85 · 27%
- Malpractice RVU2.39 · 11%
22
Medicare services in 2024 · #5874 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.
57292 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
57200 describes repair of the vagina. It does not represent creation of a vaginal canal with graft tissue.
No office rate
57295 addresses revision of a vaginal graft through a vaginal approach, not initial construction of a vagina with a graft.
No office rate
57296 addresses revision of a vaginal graft through an open abdominal approach; 57292 is for graft-based construction.
Compare 57292 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$680.95
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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 57292 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
6,471
- Code
- 57292
- Physician work
- 13.66
- Practice expense
- 5.85
- Malpractice
- 2.39
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.66 | × 1.000 | 13.6600 |
| Practice expense | 5.85 | × 1.029 | 6.0196 |
| Malpractice | 2.39 | × 0.296 | 0.7074 |
| Total RVUs | 20.3871 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$680.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.66 | 1 |
| Practice expense | 5.85 | 1.029 |
| Malpractice | 2.39 | 0.296 |
(13.66 × 1 + 5.85 × 1.029 + 2.39 × 0.296) × $33.4009 = $680.95
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.
57292 billing questions
How do I choose between 57292 and 57291?
Use 57292 when the vaginal canal is constructed with a graft. Use 57291 for construction without a graft.
Is this a repair of an existing vagina?
No. This code describes creating a vaginal canal with a graft. A repair code is considered when the operative service repairs existing vaginal tissue instead.
What documentation supports 57292?
The operative report should describe the need for construction, creation of the canal, and use of graft tissue. It should distinguish the procedure from repair or revision of an existing vagina.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the descriptor or anatomy.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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.
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
6,47357296,,Revise vag graft open abd,A,,16.15,6.26,NA,6.26,,2.83,25.24,25.24,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47457300,,Repair rectum-vagina fistula,A,,8.49,6.79,NA,6.79,,1.61,16.89,16.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002