Billing code 57109: Radical vaginectomyMedicare rate & RVUs in Ohio
Report radical vaginectomy with bilateral pelvic lymphadenectomy for definitive surgical treatment of selected vaginal malignancies requiring this extent of resection.
CMS doesn’t publish an office rate for 57109 in Ohio.
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 57109 covers
This operation removes the vagina radically for selected vaginal malignancies and includes bilateral total pelvic lymphadenectomy. A gynecologic oncologist typically performs it in an operating room, removing the vaginal disease and regional pelvic nodes as part of definitive cancer surgery; the resection depends on tumor extent and the operative plan.
Report 57109 when the operation meets the radical vaginectomy service with the included bilateral pelvic node dissection, not for a limited vaginal-wall excision or diagnostic biopsy. The operative report should establish the radical extent and document pelvic lymphadenectomy, with pathology and diagnosis supporting the cancer operation. The code is priced bilaterally, so modifier 50 does not increase payment. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and additional procedures at 50%. Assistant-at-surgery payment may be made, co-surgeons require 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.
57109 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,584.42 |
How the 57109 rate is calculated
Each of 57109’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 · 57109
RVUs × geographic indexes × conversion factor
Work27.69
27.69 RVUs× 1.000 GPCI
Practice expense14.54
14.54 RVUs× 1.000 GPCI
Malpractice6.42
6.42 RVUs× 1.000 GPCI
Adjusted RVUs
48.6500
Conversion factor
$33.4009
Medicare rate
$1,624.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57109
57109 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57109
Radical vaginectomy
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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 · 57109
Radical vaginectomy
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
57109 without 51 · national facility
$1,624.95
Radical vaginectomy
57109-51 · Second procedure: 50%
$812.48
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%).
57109 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57107Vaginectomy
- 57107 describes complete vaginal-wall removal. Use 57109 when the operation is radical and includes bilateral total pelvic lymphadenectomy.
- 57111Vaginectomy
- 57111 includes removal of paravaginal tissue with complete vaginal-wall removal. 57109 is the radical service with bilateral pelvic lymphadenectomy.
- 57100Vaginal biopsy
- 57100 is a simple vaginal mucosal biopsy for tissue sampling. 57109 is a radical cancer operation with bilateral pelvic lymphadenectomy.
57109 billing questions
When should 57109 be chosen over a complete vaginectomy code?
Use 57109 for radical vaginectomy with bilateral total pelvic lymphadenectomy. A complete vaginal-wall excision without that radical service and nodal dissection is described by a different code.
Should modifier 50 be appended?
The service is already priced as bilateral, so modifier 50 does not increase payment.
What documentation supports reporting 57109?
The operative report should describe the radical vaginal resection and bilateral pelvic lymphadenectomy. The diagnosis and pathology should support the cancer operation.
How does the global period affect related care?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other same-session procedures handled?
The highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery payment may be made; co-surgeons need 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 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
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