$96.91–$102.41
Use 57100 for simple vaginal mucosal tissue sampling. Use 57135 when the cyst or tumor itself is removed.
On this page
CMS RVU26D · Effective 2026-10-01
57135 Vaginal lesion excision Medicare reimbursement rates in Missouri
Excision of a vaginal cyst or tumor, such as a symptomatic Gartner duct cyst, when the lesion is removed rather than sampled. Compare 57135 office and facility rates across CMS payment localities in Missouri.
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 57135 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$223.45–$236.47
3 of 3 localities have a supported rate.
Facility setting
$158.95–$165.24
3 of 3 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.
Where 57135 pays more and less in Missouri
3 payment localities
$223.45 to $236.47
Gynecologic surgery
About 57135: Excision of vaginal cyst or tumor
Excision of a vaginal cyst or tumor, such as a symptomatic Gartner duct cyst, when the lesion is removed rather than sampled.
Code 57135 describes surgical removal of a cyst or tumor arising in the vagina, rather than a tissue sample taken only for diagnosis. A gynecologist typically performs the excision, removing the lesion from the vaginal wall and managing the resulting tissue defect. A symptomatic Gartner duct cyst or vaginal inclusion cyst is a familiar example. The procedure may take place in an office or an outpatient facility, depending on the lesion and the planned approach.
Choose this code when the documented service removes the vaginal cyst or tumor; document its site, clinical indication, extent of removal, and specimen findings when available. Related postoperative visits for 10 days are included in the minor-procedure global period. If other 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. Report the service once; modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon or team-surgery reporting is not permitted.
CMS billing rules for 57135
- 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 RVU2.63 · 36%
- Practice expense (office) RVU4.19 · 58%
- Malpractice RVU0.46 · 6%
898
Medicare services in 2024 · #3044 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.
57135 compared with similar codes
Office rates for Missouri, from the same CMS release.
$160.23–$170.21
57105 represents extensive vaginal mucosal biopsy, not excision of the lesion. Select 57135 when the operative service removes the cyst or tumor.
No office rate
57106 describes partial removal of vaginal wall tissue. 57135 is for removal of a vaginal cyst or tumor rather than a broader segment of wall.
No office rate
57110 describes complete vaginal wall removal, whereas 57135 addresses excision of a vaginal cyst or tumor.
Compare 57135 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$234.27
Facility
$164.01
Metropolitan St. Louis →
Office / nonfacility
$236.47
Facility
$165.24
Rest Of Missouri →
Office / nonfacility
$223.45
Facility
$158.95
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57135 billing questions
Can 57135 be used when the clinician only takes a biopsy?
No. Use 57135 when the cyst or tumor is excised; a diagnostic sample without removal is represented by a vaginal mucosal biopsy code, selected by the extent of sampling.
How does 57135 differ from vaginal wall removal codes?
57135 is for excision of a cyst or tumor. Codes for partial or complete vaginal wall removal describe more extensive removal of vaginal wall tissue, not removal of an isolated lesion.
Should modifier 50 be appended for lesions on both sides?
No. Modifier 50 is inappropriate for this service; report the excision once.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the 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.
6,44157111,,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
6,44757156,,Ins vag brachytx device,A,,2.62,3.87,,0.97,,0.21,6.70,3.80,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00