No office rate
Use 56633 for complete radical vulvar excision without the bilateral inguinofemoral lymphadenectomy included in 56637.
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CMS RVU26D · Effective 2026-10-01
56637 Radical vulvectomy Medicare reimbursement rates in Rhode Island
Reports complete radical removal of the vulva with lymph node dissection in both groins, typically for vulvar cancer requiring this extent of surgery. Compare 56637 office and facility rates across CMS payment localities in Rhode Island.
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 56637 in Rhode Island?
Rhode Island 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
$1441.88
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Gynecologic oncology surgery
About 56637: Complete radical vulvectomy with bilateral groin node removal
Reports complete radical removal of the vulva with lymph node dissection in both groins, typically for vulvar cancer requiring this extent of surgery.
A gynecologic oncologist typically performs this operation in a hospital operating room for vulvar malignancy requiring complete radical excision and bilateral inguinofemoral lymph node dissection. The procedure includes removal of the vulvar tissue and the specified groin node work on both sides; it is more extensive than a complete vulvectomy without lymphadenectomy or a partial radical excision.
Choose the code from the operative extent, not the diagnosis alone. The operative report should establish complete radical vulvar excision and lymph node dissection on both sides. The bilateral work is represented in the code, so modifier 50 is inappropriate. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. Assistant-at-surgery payment may be available, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 56637
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU24.13 · 56%
- Practice expense (office) RVU13.16 · 31%
- Malpractice RVU5.59 · 13%
70
Medicare services in 2024 · #5148 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.
56637 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Use 56634 when the complete radical operation includes unilateral groin node dissection; 56637 represents dissection on both sides.
No office rate
Use 56640 when pelvic lymph nodes are also removed with the complete radical vulvar operation and bilateral groin dissection.
No office rate
Use 56632 for radical partial vulvar excision with bilateral groin node dissection; 56637 represents complete radical excision.
Compare 56637 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$1441.88
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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 56637 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,419
- Code
- 56637
- Physician work
- 24.13
- Practice expense
- 13.16
- Malpractice
- 5.59
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.13 | × 1.019 | 24.5885 |
| Practice expense | 13.16 | × 1.033 | 13.5943 |
| Malpractice | 5.59 | × 0.892 | 4.9863 |
| Total RVUs | 43.1690 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1441.88
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.13 | 1.019 |
| Practice expense | 13.16 | 1.033 |
| Malpractice | 5.59 | 0.892 |
(24.13 × 1.019 + 13.16 × 1.033 + 5.59 × 0.892) × $33.4009 = $1441.88
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.
56637 billing questions
How does this differ from code 56634?
This code represents complete radical vulvar excision with lymph node dissection on both sides. Code 56634 describes the corresponding complete radical operation with unilateral inguinofemoral lymphadenectomy.
Should modifier 50 be added?
No. The code already represents bilateral groin node dissection, and CMS identifies modifier 50 as inappropriate for this service.
Are the groin node dissections separately reported?
The bilateral inguinofemoral lymphadenectomy is included in this code. The operative documentation should support node dissection on both sides.
What documentation supports choosing this code?
The operative report should describe complete radical excision of the vulva and lymph node dissection in both groins. A cancer diagnosis by itself does not establish the operative extent.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available, and co-surgeons are permitted under the CMS facts for this code. 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.
6,41656632,,Vlvctmy rad prtl bi lymphad,A,,21.31,14.09,NA,14.09,,4.64,40.04,40.04,0,090,0.12,0.74,0.14,2,2,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41756633,,Vulvectomy radical complete,A,,19.13,11.13,NA,11.13,,4.19,34.45,34.45,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41856634,,Vlvctmy rad comp uni lymphad,A,,20.14,11.99,NA,11.99,,4.66,36.79,36.79,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,41956637,,Vlvctmy rad comp bi lymphad,A,,24.13,13.16,NA,13.16,,5.59,42.88,42.88,0,090,0.12,0.74,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42056640,,Vlvctmy rad comp w/lymphadec,A,,24.16,13.13,NA,13.13,,5.59,42.88,42.88,0,090,0.12,0.74,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42156700,,Prtl hymnctmy/revj hymnl rng,A,,2.77,2.19,NA,2.19,,0.48,5.44,5.44,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,42256740,,Exc bartholins gland/cyst,A,,4.76,2.84,NA,2.84,,0.87,8.47,8.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537