No office rate
Use 57311 when the fistula repair is performed through an abdominal approach; 57310 is for the vaginal approach.
On this page
CMS RVU26D · Effective 2026-10-01
57311 Fistula repair Medicare reimbursement rates in Oregon
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 Oregon.
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 Oregon?
Oregon 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
$492.20–$518.66
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.
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 Oregon, from the same CMS release.
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.
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.
2 of 2 payment localities
Portland →
Office / nonfacility
Unavailable
Facility
$518.66
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$492.20
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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.
6,47657307,,Fistula repair & colostomy,A,,16.74,10.74,NA,10.74,,2.41,29.89,29.89,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47757308,,Fistula repair transperine,A,,10.33,7.07,NA,7.07,,1.48,18.88,18.88,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47857310,,Repair urethrovaginal lesion,A,,7.46,5.02,NA,5.02,,0.96,13.44,13.44,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,47957311,,Repair urethrovaginal lesion,A,,8.69,5.28,NA,5.28,,1.12,15.09,15.09,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48057320,,Repair bladder-vagina lesion,A,,8.66,4.86,NA,4.86,,1.50,15.02,15.02,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48157330,,Repair bladder-vagina lesion,A,,12.88,6.09,NA,6.09,,1.65,20.62,20.62,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48257335,,Repair vagina,A,,19.52,8.07,NA,8.07,,3.43,31.02,31.02,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00