Billing code 57065: Vaginal lesion destructionMedicare rate & RVUs in Texas
Reports destruction of extensive vaginal lesions, such as broad or multiple condylomata or dysplastic lesions, using an ablative treatment approach.
Medicare pays $228.13–$248.42 for 57065 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 57065 covers
billing code 57065 describes destruction of extensive lesions on the vaginal mucosa. A gynecologist typically performs the treatment using an ablative technique for lesions such as vaginal condylomata or dysplastic lesions. The procedure may take place in an office procedure room or operating room, depending on the lesion burden and planned anesthesia. Lesions on the vulva are coded separately from lesions within the vagina.
Choose this code when the documented extent supports the extensive-lesion service rather than the simple-lesion service; the operative note should identify the treated vaginal sites, extent, and treatment performed. This minor procedure has a 10-day global period, so related postoperative visits during that 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% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.
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.
Where 57065 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$228.13 to $248.42
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $248.42 | $168.20 |
| Beaumont | $228.13 | $159.13 |
| Brazoria | $237.95 | $162.81 |
| Dallas | $239.91 | $164.39 |
| Fort Worth | $238.70 | $163.94 |
| Galveston | $238.95 | $163.66 |
| Houston | $247.18 | $171.89 |
| Rest Of Texas | $233.21 | $161.26 |
How the 57065 rate is calculated
Each of 57065’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 57065
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.59Practice expense 4.20Malpractice 0.45
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57065
57065 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57065
Vaginal lesion destruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57065
Vaginal lesion destruction
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57065 without 51 · national office
$241.82
Vaginal lesion destruction
57065-51 · Second procedure: 50%
$120.91
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
57065 compared with similar codes
Compare codes
57065 vs 57061 vs 56515 vs 56501 vs 57100: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57061Vaginal lesion destruction
- Both codes describe vaginal lesion destruction. Choose 57065 for extensive lesions and 57061 for simple lesions, based on the documented extent.
- 56515Vulvar lesion destruction
- This is the extensive-lesion destruction code for the vulva. Use 57065 for lesions on the vaginal mucosa.
- 56501Vulvar lesion destruction
- This describes simple destruction of vulvar lesions. It differs from 57065 in both the treated site and the extent represented.
- 57100Vaginal biopsy
- This code represents biopsy of vaginal mucosa for tissue sampling; 57065 represents destruction of extensive vaginal lesions.
57065 billing questions
How do I choose 57065 instead of 57061?
Use 57065 when the documentation supports extensive vaginal lesions; 57061 is for simple vaginal lesions. Document the treated sites and extent rather than relying on lesion count alone.
Can I append modifier 50 when lesions are on both sides?
No. The CMS bilateral adjustment does not apply to 57065, and modifier 50 is inappropriate.
Are postoperative visits separately billable?
Related postoperative visits during the 10-day global period are included in the procedure.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Does 57065 cover lesions on the vulva?
No. This code concerns vaginal lesions; vulvar lesion destruction is represented by the corresponding vulvar code selected for its documented extent.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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