No office rate
This code describes partial hymenectomy or hymenal ring revision. Choose 56442 for a simple incision of hymenal tissue.
On this page
CMS RVU26D · Effective 2026-10-01
56700 Hymenal surgery Medicare reimbursement rates in Nebraska
Reports partial removal of hymenal tissue or revision of a restrictive hymenal ring, such as when the tissue causes symptoms or limits vaginal opening. Compare 56700 office and facility rates across CMS payment localities in Nebraska.
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 56700 in Nebraska?
Nebraska 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
$166.10
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 56700: Partial hymenectomy or hymenal ring revision
Reports partial removal of hymenal tissue or revision of a restrictive hymenal ring, such as when the tissue causes symptoms or limits vaginal opening.
A gynecologist typically performs this procedure to remove part of the hymen or revise a hymenal ring that is restrictive, thickened, or scarred. Patients may have symptoms such as difficulty with tampon insertion or pain related to the hymenal opening. The service is performed in a surgical setting, with the operative work directed at the hymenal tissue rather than a broader repair of the vaginal opening or perineum.
Choose this code when the documented operation involves partial hymenectomy or revision of the hymenal ring; a simple incision of hymenal tissue is a different service. The operative note should identify the tissue treated, the reason for surgery, and the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same 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 service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 56700
- 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
- 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 RVU2.77 · 51%
- Practice expense (office) RVU2.19 · 40%
- Malpractice RVU0.48 · 9%
42
Medicare services in 2024 · #5470 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.
56700 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
This code is for repair of the introitus. Choose 56700 when the operative work is confined to partial removal or revision of the hymenal ring.
No office rate
This code addresses perineal repair. Choose 56700 when the documented procedure treats the hymen or hymenal ring instead.
Compare 56700 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$166.10
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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 56700 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
6,421
- Code
- 56700
- Physician work
- 2.77
- Practice expense
- 2.19
- Malpractice
- 0.48
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.77 | × 1.000 | 2.7700 |
| Practice expense | 2.19 | × 0.923 | 2.0214 |
| Malpractice | 0.48 | × 0.378 | 0.1814 |
| Total RVUs | 4.9728 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$166.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.77 | 1 |
| Practice expense | 2.19 | 0.923 |
| Malpractice | 0.48 | 0.378 |
(2.77 × 1 + 2.19 × 0.923 + 0.48 × 0.378) × $33.4009 = $166.10
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.
56700 billing questions
How does this differ from a simple hymenotomy?
Use 56700 for partial removal of hymenal tissue or revision of the hymenal ring. A simple incision of hymenal tissue is represented by 56442.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this service and anatomy.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports the code?
Document the hymenal tissue treated, the symptoms or clinical reason for surgery, and whether the work was partial excision or revision rather than a simple incision.
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.
6,41856634,,Vlvctmy rad comp uni lymphad,A,,20.14,11.99,NA,11.99,,4.66,36.79,36.79,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41956637,,Vlvctmy rad comp bi lymphad,A,,24.13,13.16,NA,13.16,,5.59,42.88,42.88,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42056640,,Vlvctmy rad comp w/lymphadec,A,,24.16,13.13,NA,13.13,,5.59,42.88,42.88,0,090,0.12,0.74,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42156700,,Prtl hymnctmy/revj hymnl rng,A,,2.77,2.19,NA,2.19,,0.48,5.44,5.44,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42256740,,Exc bartholins gland/cyst,A,,4.76,2.84,NA,2.84,,0.87,8.47,8.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42356800,,Plastic repair introitus,A,,3.83,2.31,NA,2.31,,0.66,6.80,6.80,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42456805,,Clitoroplasty intersex state,A,,19.38,7.89,NA,7.89,,3.39,30.66,30.66,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068