Billing code 56420: Abscess drainageMedicare rate & RVUs in Utah
Drainage of a Bartholin gland abscess, typically performed for a painful, localized vulvar collection at the gland’s duct opening.
Medicare pays $173.58 for 56420 in the office in Utah (Utah). 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 56420 covers
billing code 56420 describes opening and draining an abscess involving a Bartholin gland, commonly presenting as a tender, one-sided swelling near the vaginal opening. A gynecologist or another physician may perform the procedure in an office, clinic, or facility setting. The service addresses an abscess; a noninfected Bartholin cyst or an abscess elsewhere on the vulva calls for a different procedural choice.
Report the code when the documented procedure drains a Bartholin gland abscess. The note should identify the gland or site and describe the abscess and drainage performed. The 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 multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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.
56420 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $173.58 | $96.66 |
How the 56420 rate is calculated
Each of 56420’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 · 56420
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.40Practice expense 3.81Malpractice 0.24
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 56420
56420 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 56420
Abscess drainage
| 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 · 56420
Abscess drainage
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
56420 without 51 · national office
$182.03
Abscess drainage
56420-51 · Second procedure: 50%
$91.02
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%).
56420 compared with similar codes
Compare codes
56420 vs 56405 vs 56440 vs 56740: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 56405Abscess drainage
- Choose 56420 when the abscess involves the Bartholin gland; choose 56405 for a vulvar or perineal abscess at another site.
- 56440Cyst marsupialization
- 56420 reports drainage of a Bartholin gland abscess. 56440 reports marsupialization of a Bartholin gland cyst.
- 56740Bartholin excision
- 56420 is drainage of an abscess; 56740 is excision of the Bartholin gland.
56420 billing questions
How do I distinguish 56420 from 56405?
Use 56420 for an abscess of the Bartholin gland. Code 56405 is for incision and drainage of a vulvar or perineal abscess not identified as a Bartholin gland abscess.
How does 56420 differ from 56440?
56420 is for draining a Bartholin gland abscess. 56440 describes marsupialization of a Bartholin gland cyst, a different procedure.
Should modifier 50 be appended for bilateral disease?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. An assistant at surgery is not paid; 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 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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