No office rate
57425 suspends the vaginal apex laparoscopically; 57423 repairs a paravaginal defect laparoscopically. Choose according to the structure repaired in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
57425 Laparoscopic colpopexy Medicare reimbursement rates in Pennsylvania
Reports laparoscopic suspension of the vaginal apex, commonly for post-hysterectomy vault prolapse, when the surgeon performs a laparoscopic colpopexy. Compare 57425 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 57425 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
No supported rate
Facility setting
$837.49–$896.55
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.
Gynecologic surgery
About 57425: Laparoscopic vaginal apex suspension
Reports laparoscopic suspension of the vaginal apex, commonly for post-hysterectomy vault prolapse, when the surgeon performs a laparoscopic colpopexy.
The surgeon uses a laparoscopic approach to suspend the vaginal apex, often attaching the vaginal cuff to the sacrum with a graft during repair of post-hysterectomy vault prolapse. Urogynecologists and gynecologic surgeons typically perform this operation in a hospital or ambulatory surgical setting. The operative report should establish the laparoscopic approach and the actual suspension of the vaginal apex; a diagnosis of prolapse alone does not identify this procedure.
Report the service for the laparoscopic suspension, distinguishing it from laparoscopic repair of a paravaginal defect or an open or vaginal approach to colpopexy. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57425
- 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 RVU16.60 · 64%
- Practice expense (office) RVU6.40 · 25%
- Malpractice RVU2.75 · 11%
15.5K
Medicare services in 2024 · #1242 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.
57425 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
57425 describes laparoscopic colpopexy, while 57426 describes laparoscopic revision of a prosthetic vaginal graft. A graft revision is not the primary suspension.
No office rate
Both involve colpopexy, but 57425 is laparoscopic and 57280 uses an abdominal approach. The documented operative approach distinguishes them.
No office rate
57282 is a vaginal, extraperitoneal colpopexy; 57425 is performed laparoscopically. Select the code that matches the surgeon’s approach.
Compare 57425 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
Unavailable
Facility
$896.55
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$837.49
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57425 billing questions
When should I report 57425 instead of 57423?
Report 57425 for laparoscopic suspension of the vaginal apex. Code 57423 describes laparoscopic repair of a paravaginal defect, a different operative target.
Does this code describe a laparoscopic or open procedure?
It describes laparoscopic colpopexy. An abdominal colpopexy performed through an open approach is distinguished by the operative approach, not simply by the prolapse diagnosis.
What documentation supports 57425?
The operative report should document the laparoscopic approach and suspension of the vaginal apex, including the attachment site and any graft or fixation method used.
Is modifier 50 appropriate for this service?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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.
6,48657420,,Exam of vagina w/scope,A,,1.56,2.26,,0.57,,0.30,4.12,2.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48757421,,Exam/biopsy of vag w/scope,A,,2.15,2.88,,0.70,,0.42,5.45,3.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48857423,,Repair paravag defect lap,A,,15.68,6.23,NA,6.23,,2.67,24.58,24.58,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48957425,,Laparoscopy surg colpopexy,A,,16.60,6.40,NA,6.40,,2.75,25.75,25.75,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,49057426,,Revise prosth vag graft lap,A,,13.94,6.96,NA,6.96,,2.33,23.23,23.23,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,49157452,,Exam of cervix w/scope,A,,1.46,2.04,,0.75,,0.26,3.76,2.47,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,49257454,,Bx/curett of cervix w/scope,A,,2.27,2.30,,0.89,,0.40,4.97,3.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,57452,33.4009,09,0,99,0.00,0.00,0.00