Billing code 57296: Vaginal graft revisionMedicare rate & RVUs in Oklahoma
Reports abdominal revision or removal of previously placed vaginal graft material when the surgeon must address the graft through an open abdominal approach.
CMS doesn’t publish an office rate for 57296 in Oklahoma.
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 57296 covers
A surgeon revises or removes previously implanted graft material supporting the vagina, reaching it through an open abdominal incision. The operation may address a problem with an existing graft used in pelvic floor reconstruction. It is distinct from revising graft material through the vagina and from operating on a urethral sling. These cases are generally performed by gynecologic or urogynecologic surgeons in a facility setting.
Select this code when the operative report identifies revision or removal of vaginal graft material and documents the open abdominal route; the approach and the work on the existing graft distinguish it from initial graft placement or repair of a separate pelvic support defect. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate.
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.
57296 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $799.59 |
How the 57296 rate is calculated
Each of 57296’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 · 57296
RVUs × geographic indexes × conversion factor
Work16.15
16.15 RVUs× 1.000 GPCI
Practice expense6.26
6.26 RVUs× 1.000 GPCI
Malpractice2.83
2.83 RVUs× 1.000 GPCI
Adjusted RVUs
25.2400
Conversion factor
$33.4009
Medicare rate
$843.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 57296
57296 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57296
Vaginal graft revision
| 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 · 57296
Vaginal graft revision
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
57296 without 51 · national facility
$843.04
Vaginal graft revision
57296-51 · Second procedure: 50%
$421.52
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%).
57296 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57295Vaginal graft revision
- Both address revision or removal of vaginal graft material. Choose 57296 for the open abdominal approach and 57295 for the vaginal approach.
- 57287Sling revision
- This code addresses vaginal graft material; 57287 is for revision or removal of a urethral sling. Identify the implant being treated.
- 57284Paravaginal repair
- This code revises or removes existing vaginal graft material. Code 57284 addresses open repair of a paravaginal defect, not graft revision.
57296 billing questions
How is this distinguished from 57295?
This code is for revision or removal of vaginal graft material through an open abdominal approach. Code 57295 describes the vaginal approach.
Is this the right code for revising a urethral sling?
No. This code concerns vaginal graft material; code 57287 addresses revision or removal of a sling. The operative report should identify the implanted material and the work performed.
Can the initial graft placement be reported with this code?
This code reports work on previously placed graft material, not its initial placement. Report only services supported as distinct procedures by the operative documentation.
What documentation supports the abdominal approach?
The operative report should identify the existing vaginal graft, the reason for revision or removal, the work performed on it, and the open abdominal route.
Can modifier 50 be used for bilateral work?
No. Modifier 50 is inappropriate for this code.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The code has a 90-day global period.
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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