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CMS RVU26D · Effective 2026-10-01

57311 Fistula repair Medicare reimbursement rates in Oklahoma

Reports abdominal repair of a urethrovaginal fistula, an abnormal connection between the urethra and vagina that causes urine to leak into the vagina. Compare 57311 office and facility rates across CMS payment localities in Oklahoma.

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 57311 in Oklahoma?

Oklahoma 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

$476.81

1 of 1 localities have a supported rate.

Payment area: Oklahoma

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.

Find 57311 in your payment locality →

Urologic surgery

About 57311: Abdominal urethrovaginal fistula repair

Reports abdominal repair of a urethrovaginal fistula, an abnormal connection between the urethra and vagina that causes urine to leak into the vagina.

This service repairs a fistula connecting the urethra with the vagina through an abdominal surgical approach. The defect can cause continuous or persistent urinary leakage into the vagina. A urologist, urogynecologist, or gynecologic surgeon typically performs the repair in a hospital or other facility. The operative report should identify the urethrovaginal tract and show that the abdominal route was used; the vaginal-route repair is a different code.

Report one unit for the repair and support the code with the fistula anatomy, operative approach, and work performed. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Modifier 50 is not appropriate. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 57311

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU8.69 · 58%
  • Practice expense (office) RVU5.28 · 35%
  • Malpractice RVU1.12 · 7%

24

Medicare services in 2024 · #5821 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.

57311 compared with similar codes

Office rates for Oklahoma, from the same CMS release.

57310

Fistula repair

Urethrovaginal, vaginal approach

No office rate

Use 57311 when the fistula repair is performed through an abdominal approach; 57310 is for the vaginal approach.

57320

Fistula repair

Vaginal approach

No office rate

This code addresses a fistula between the bladder and vagina through a vaginal approach. Code 57311 is for a urethra-to-vagina fistula repaired abdominally.

57330

Fistula repair

Abdominal approach

No office rate

This code addresses a bladder-to-vagina fistula repaired abdominally. Choose 57311 when the fistula instead connects the urethra and vagina.

Compare 57311 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

Office and facility base rates · shared scale starting at $0

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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 57311 in Oklahoma.

PPRRVU2026_Oct_nonQPP.csv

6,479

Code
57311
Physician work
8.69
Practice expense
5.28
Malpractice
1.12

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Facility calculation for 57311 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work8.69× 1.0008.6900
Practice expense5.28× 0.8934.7150
Malpractice1.12× 0.7770.8702
Total RVUs14.2753
Conversion factor× 33.4009

Facility rate, Oklahoma$476.81

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work8.691
Practice expense5.280.893
Malpractice1.120.777

(8.69 × 1 + 5.28 × 0.893 + 1.12 × 0.777) × $33.4009 = $476.81

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.

57311 billing questions

How does this differ from 57310?

Both codes address a urethrovaginal fistula, but 57311 is for repair through an abdominal approach. Code 57310 describes the vaginal approach.

What documentation supports reporting 57311?

Document the connection between the urethra and vagina, the abdominal route used, and the operative repair performed. The record should make clear that this was not a vaginal-route repair.

Can modifier 50 be used?

No. A bilateral adjustment is not appropriate for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction. Related postoperative care is included in the 90-day global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires 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 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.

RVUs for 57311PPRRVU2026_Oct_nonQPP.csv, line 6,479 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet