No office rate
Use 57285 for the vaginal route to a paravaginal defect; 57284 describes the open abdominal route.
On this page
CMS RVU26D · Effective 2026-10-01
57285 Paravaginal repair Medicare reimbursement rates in New Jersey
Reports vaginal reconstruction of a lateral vaginal support defect, commonly performed for prolapse caused by detachment of the vaginal wall from its pelvic support. Compare 57285 office and facility rates across CMS payment localities in New Jersey.
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 57285 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$652.16–$670.81
2 of 2 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.
Urogynecologic surgery
About 57285: Vaginal paravaginal defect repair
Reports vaginal reconstruction of a lateral vaginal support defect, commonly performed for prolapse caused by detachment of the vaginal wall from its pelvic support.
A urogynecologist, gynecologist, or pelvic reconstructive surgeon uses a vaginal route to restore support where the lateral vaginal wall has separated from its pelvic attachment. The repair may address an associated cystocele when that correction is part of the same operation. It is typically performed in a facility operating room for vaginal prolapse caused by a paravaginal defect.
Choose this code when the operative report documents repair of the lateral support defect through the vagina, rather than a central anterior wall repair or an abdominal approach. The note should identify the defect, route, and repair performed. The 90-day global includes 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 others are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate for this code.
CMS billing rules for 57285
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.31 · 61%
- Practice expense (office) RVU5.20 · 28%
- Malpractice RVU1.90 · 10%
815
Medicare services in 2024 · #3128 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.
57285 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
57240 addresses anterior vaginal wall repair, typically a central defect. This code is for restoring lateral vaginal support; a cystocele repaired as part of that work is included.
No office rate
57260 combines anterior and posterior vaginal wall repairs. It is not the specific choice for a lateral paravaginal defect repaired vaginally.
Compare 57285 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
Unavailable
Facility
$670.81
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$652.16
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57285 billing questions
How does this differ from 57284?
Both address a paravaginal support defect, but 57285 uses a vaginal route. Code 57284 is the open abdominal approach.
Can 57240 also be reported for a cystocele?
A cystocele corrected as part of the paravaginal repair is included in this service. Do not separately report 57240 for the same repair work; document any distinct, separately performed anterior wall repair clearly.
Can mesh insertion be reported with this repair?
When qualifying mesh or another prosthesis is inserted for the pelvic floor defect, 57267 is the related add-on code. The operative note should support the insertion and site.
Should modifier 50 be used for bilateral repair?
No. The code's anatomy and descriptor make modifier 50 inappropriate.
How are assistant and co-surgeon services treated?
CMS permits payment for an assistant at surgery and for co-surgeons. Team surgery is not permitted for this code.
What postoperative care is included?
The 90-day global period includes the preoperative visit on the day before surgery and 90 days of related postoperative care.
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.
6,46357282,,Colpopexy extraperitoneal,A,,11.34,5.21,NA,5.21,,1.87,18.42,18.42,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46457283,,Colpopexy intraperitoneal,A,,11.37,5.21,NA,5.21,,1.95,18.53,18.53,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46557284,,Repair paravag defect open,A,,13.97,5.67,NA,5.67,,2.46,22.10,22.10,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46657285,,Repair paravag defect vag,A,,11.31,5.20,NA,5.20,,1.90,18.41,18.41,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46757287,,Revise/remove sling repair,A,,10.87,7.17,NA,7.17,,1.72,19.76,19.76,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,46857288,,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