$174.31–$192.71
Choose 56515 for extensive vulvar lesion destruction and 56501 for simple destruction. The documented extent of treatment separates the two.
On this page
CMS RVU26D · Effective 2026-10-01
56515 Vulvar lesion destruction Medicare reimbursement rates in Pennsylvania
Reports extensive destruction of vulvar lesions, such as widespread lesions treated during a gynecologic procedure using a destructive technique. Compare 56515 office and facility rates across CMS payment localities in Pennsylvania.
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 56515 in Pennsylvania?
Pennsylvania 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
$259.49–$284.71
2 of 2 localities have a supported rate.
Facility setting
$183.14–$198.13
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.
Gynecology
About 56515: Extensive vulvar lesion destruction
Reports extensive destruction of vulvar lesions, such as widespread lesions treated during a gynecologic procedure using a destructive technique.
This code describes extensive destruction of one or more lesions on the vulva. A gynecologist or other qualified clinician may use an appropriate destructive technique, such as laser treatment, electrosurgery, cryotherapy, or chemical destruction. A typical clinical setting is treatment of extensive vulvar condylomata; the code is selected for the documented extent of treatment, not for a particular device or technique.
The operative note should identify the vulvar sites treated, describe the extent of the lesions and work performed, and record the method used. Use the simple-lesion code when the treatment is not extensive. Related postoperative visits during the 10-day global period are included. 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 inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 56515
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.00 · 37%
- Practice expense (office) RVU4.67 · 57%
- Malpractice RVU0.51 · 6%
2.5K
Medicare services in 2024 · #2295 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.
56515 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
This code describes destruction of extensive vulvar lesions; 56620 describes partial simple vulvectomy, an excisional procedure.
No office rate
Use 56515 for destructive treatment of extensive lesions. Code 56625 describes complete simple vulvectomy, not lesion destruction.
Compare 56515 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
Metropolitan Philadelphia →
Office / nonfacility
$284.71
Facility
$198.13
Rest Of Pennsylvania →
Office / nonfacility
$259.49
Facility
$183.14
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56515 billing questions
How is this code distinguished from 56501?
56515 is for extensive vulvar lesion destruction. Use 56501 when the destruction is simple; document the treatment extent rather than relying only on lesion count.
Is the code reported once for each lesion?
It describes extensive treatment of vulvar lesion(s), rather than a separate unit for every lesion. Document the sites and overall extent treated in the session.
Should modifier 50 be appended for lesions on both sides?
No. Modifier 50 is inappropriate for this service, even when treatment involves both sides of the vulva.
Are related postoperative visits separately payable during the global period?
Related postoperative visits for 10 days are included in the procedure's global period.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
6,40656441,,Lysis of labial adhesions,A,,1.97,3.15,,1.90,,0.34,5.46,4.21,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40756442,,Hymenotomy,A,,0.66,0.53,NA,0.53,,0.12,1.31,1.31,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40856501,,Destroy vulva lesions sim,A,,1.54,3.75,,1.80,,0.25,5.54,3.59,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,40956515,,Destroy vulva lesion/s compl,A,,3.00,4.67,,2.18,,0.51,8.18,5.69,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41056605,,Biopsy of vulva/perineum,A,,1.07,1.54,,0.29,,0.19,2.80,1.55,0,000,0.00,0.00,0.00,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41156606,,Biopsy of vulva/perineum,A,,0.54,0.54,,0.13,,0.09,1.17,0.76,0,ZZZ,0.00,0.00,0.00,0,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41256620,,Vulvectomy simple partial,A,,7.34,7.52,NA,7.52,,1.51,16.37,16.37,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00