Billing code 57320: Fistula repairMedicare rate & RVUs in Missouri
Reports surgical closure through the vagina of an abnormal connection between the bladder and vagina, commonly causing continuous urinary leakage.
CMS doesn’t publish an office rate for 57320 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 57320 covers
This service closes a vesicovaginal fistula, an abnormal passage that allows urine to move from the bladder into the vagina. A gynecologic surgeon or urologist typically performs the repair in an operating room, using vaginal access to expose and close the fistula. These repairs may be needed after pelvic surgery or other injury to the tissues; patients often present with persistent urinary leakage through the vagina.
Select this code when the operative report supports a bladder-to-vagina fistula and a vaginal route of repair. Document the fistula’s location, the approach, and the operative work performed. Medicare 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the repair once rather than as a bilateral service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 57320 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | Unavailable | $490.63 |
| Metropolitan St. Louis | Unavailable | $493.99 |
| Rest Of Missouri | Unavailable | $477.98 |
How the 57320 rate is calculated
Each of 57320’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 57320
RVUs × geographic indexes × conversion factor
Work8.66
8.66 RVUs× 1.000 GPCI
Practice expense4.86
4.86 RVUs× 1.000 GPCI
Malpractice1.50
1.50 RVUs× 1.000 GPCI
Adjusted RVUs
15.0200
Conversion factor
$33.4009
Medicare rate
$501.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57320
57320 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57320
Fistula repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57320
Fistula repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57320 without 51 · national facility
$501.68
Fistula repair
57320-51 · Second procedure: 50%
$250.84
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
57320 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57330Fistula repair
- Both codes address a vesicovaginal fistula. Choose based on the operative route: vaginal for 57320 and abdominal for 57330.
- 57310Fistula repair
- Use 57310 when the fistula connects the urethra and vagina; 57320 is for a connection between the bladder and vagina.
- 57311Fistula repair
- This code concerns urethrovaginal fistula repair by an abdominal approach. For bladder-to-vagina repair, distinguish the route and use 57320 for vaginal access or 57330 for abdominal access.
57320 billing questions
When should 57320 be chosen instead of 57330?
Use 57320 for a vesicovaginal fistula repaired through the vagina. Code 57330 describes repair of the same type of fistula through an abdominal approach.
How does 57320 differ from urethrovaginal fistula repair?
The involved structures determine the code: 57320 is for a connection between bladder and vagina, while 57310 and 57311 concern a connection between urethra and vagina.
Is modifier 50 appropriate for this repair?
No. Report the repair once for the fistula; the anatomy does not support bilateral reporting with modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted for this service.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 57320 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →