No office rate
Choose 57300 for rectovaginal fistula closure through a vaginal or transanal route; choose 57308 when the surgeon uses a transperineal route.
On this page
CMS RVU26D · Effective 2026-10-01
57308 Fistula repair Medicare reimbursement rates in Missouri
Reports surgical closure of a rectovaginal fistula through the perineum, when the operative approach is transperineal. Compare 57308 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 57308 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
No supported rate
Facility setting
$596.74–$619.37
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 57308 pays more and less in Missouri
Gynecologic surgery
About 57308: Transperineal rectovaginal fistula repair
Reports surgical closure of a rectovaginal fistula through the perineum, when the operative approach is transperineal.
This operation closes an abnormal tract between the rectum and vagina using access through the perineum. It may be performed by a gynecologic surgeon, urogynecologist, or colorectal surgeon in an operating room, including for fistulas related to obstetric injury or prior pelvic surgery. The operative approach, rather than the fistula’s cause, distinguishes this code from other rectovaginal fistula repairs.
Report one unit for the transperineal repair and document the fistula’s anatomy and the route used to reach and close it. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate; report the repair as a single procedure. Assistant-at-surgery payment may be available, and co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 57308
- 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 RVU10.33 · 55%
- Practice expense (office) RVU7.07 · 37%
- Malpractice RVU1.48 · 8%
38
Medicare services in 2024 · #5531 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.
57308 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
57305 uses an abdominal approach for rectovaginal fistula closure. The approach for 57308 is transperineal.
No office rate
57307 describes abdominal rectovaginal fistula repair with colostomy. Code 57308 identifies transperineal closure.
No office rate
57310 concerns a urethrovaginal fistula, not a tract between the rectum and vagina.
Compare 57308 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
Unavailable
Facility
$615.07
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$619.37
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$596.74
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57308 billing questions
How does 57308 differ from 57300?
Both address rectovaginal fistula closure, but 57308 uses a transperineal route. Code 57300 is selected for a vaginal or transanal approach.
When is 57305 or 57307 the better choice?
Those codes describe an abdominal approach to rectovaginal fistula closure. Code 57307 also identifies repair with colostomy; 57308 is for the transperineal approach.
What documentation supports reporting 57308?
The operative report should identify the rectovaginal fistula and describe the transperineal route used for its closure.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this single-anatomy repair; report the transperineal procedure without it.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and 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.
6,47457300,,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
6,47557305,,Repair rectum-vagina fistula,A,,14.97,8.98,NA,8.98,,2.97,26.92,26.92,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47657307,,Fistula repair & colostomy,A,,16.74,10.74,NA,10.74,,2.41,29.89,29.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47757308,,Fistula repair transperine,A,,10.33,7.07,NA,7.07,,1.48,18.88,18.88,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47857310,,Repair urethrovaginal lesion,A,,7.46,5.02,NA,5.02,,0.96,13.44,13.44,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47957311,,Repair urethrovaginal lesion,A,,8.69,5.28,NA,5.28,,1.12,15.09,15.09,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48057320,,Repair bladder-vagina lesion,A,,8.66,4.86,NA,4.86,,1.50,15.02,15.02,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00