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CMS RVU26D · Effective 2026-10-01

57423 Paravaginal repair Medicare reimbursement rates in Rhode Island

Report laparoscopic repair when the surgeon restores lateral support to the anterior vaginal wall for a paravaginal defect, including associated cystocele repair. Compare 57423 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 57423 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

$828.18

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.

Find 57423 in your payment locality →

Gynecologic surgery

About 57423: Laparoscopic paravaginal defect repair

Report laparoscopic repair when the surgeon restores lateral support to the anterior vaginal wall for a paravaginal defect, including associated cystocele repair.

A surgeon repairs a paravaginal defect laparoscopically by restoring the anterior vaginal wall’s lateral support where it has separated from the pelvic sidewall. The operation is commonly performed by a gynecologist or urogynecologist in a hospital or ambulatory surgery facility for pelvic organ prolapse. Cystocele repair performed as part of this repair is included; the code is not for an examination or for apical suspension alone.

Select the code when the operative report supports laparoscopic repair of the paravaginal defect, rather than a vaginal-route repair or a different prolapse procedure. Document the defect, approach, repair performed, and any associated cystocele work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery and co-surgeon reporting may be paid; team surgery is not permitted.

CMS billing rules for 57423

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 RVU15.68 · 64%
  • Practice expense (office) RVU6.23 · 25%
  • Malpractice RVU2.67 · 11%

1K

Medicare services in 2024 · #2960 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.

57423 compared with similar codes

Office rates for Rhode Island, from the same CMS release.

57284

Paravaginal repair

Open abdominal approach

No office rate

Choose 57284 for vaginal-route paravaginal defect repair; choose 57423 when the repair is performed laparoscopically.

57240

Anterior repair

Anterior compartment only

No office rate

Code 57240 describes anterior colporrhaphy for cystocele or anterior wall prolapse. Code 57423 is specific to laparoscopic restoration of paravaginal support.

57425

Laparoscopic colpopexy

Vaginal apex suspension

No office rate

Code 57425 is for laparoscopic suspension of the vaginal apex. Code 57423 repairs lateral support of the anterior vaginal wall.

57426

Vaginal graft revision

Laparoscopic approach

No office rate

Code 57426 is for laparoscopic revision of a prosthetic vaginal graft. It is not the code for an initial paravaginal defect repair.

Compare 57423 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 57423 in Rhode Island.

PPRRVU2026_Oct_nonQPP.csv

6,488

Code
57423
Physician work
15.68
Practice expense
6.23
Malpractice
2.67

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 57423 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work15.68× 1.01915.9779
Practice expense6.23× 1.0336.4356
Malpractice2.67× 0.8922.3816
Total RVUs24.7951
Conversion factor× 33.4009

Facility rate, Rhode Island$828.18

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work15.681.019
Practice expense6.231.033
Malpractice2.670.892

(15.68 × 1.019 + 6.23 × 1.033 + 2.67 × 0.892) × $33.4009 = $828.18

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.

57423 billing questions

How does this differ from code 57284?

Both address a paravaginal defect, but 57423 is for laparoscopic repair and 57284 is for the vaginal approach. The operative route determines the choice.

Can cystocele repair be reported separately?

Cystocele repair performed as part of the paravaginal repair is included. Do not separately report another code for the same repair work.

Is modifier 50 appropriate for bilateral repair?

No. CMS identifies bilateral adjustment as inapplicable for this code, and modifier 50 is inappropriate.

What documentation supports 57423?

The operative report should identify the paravaginal defect, confirm the laparoscopic approach, and describe the repair and any associated cystocele work.

Can an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery and permits co-surgeons. Team surgery is not permitted for this code.

How is it paid when other procedures occur in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Related postoperative care is included in the 90-day global period.

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 57423PPRRVU2026_Oct_nonQPP.csv, line 6,488 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet