Billing code 57105: Vaginal biopsyMedicare rate & RVUs in Utah
Reports extensive sampling of abnormal vaginal mucosa for histologic assessment, such as broad or multifocal lesions, when the documented biopsy exceeds a simple mucosal biopsy.
Medicare pays $167.78 for 57105 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 57105 covers
An extensive vaginal mucosal biopsy removes tissue from a broad or multifocal abnormal area for histologic evaluation. Gynecologists and gynecologic oncologists may perform it in an office or facility setting when examination identifies suspicious vaginal mucosa, such as persistent lesions or changes concerning for vaginal intraepithelial neoplasia or malignancy. The code reflects the extent of the biopsy service, not simply a stated number of tissue fragments.
Choose 57105 rather than 57100 when the documented biopsy work is extensive. Record the lesion distribution and appearance, sites sampled, and extent of tissue collection. The code has a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50 for bilateral vaginal biopsy. Medicare does not pay an assistant at surgery for this service; 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.
57105 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $167.78 | $130.42 |
How the 57105 rate is calculated
Each of 57105’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 · 57105
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.70Practice expense 3.22Malpractice 0.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57105
57105 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57105
Vaginal biopsy
| 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 · 57105
Vaginal biopsy
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
57105 without 51 · national office
$175.35
Vaginal biopsy
57105-51 · Second procedure: 50%
$87.68
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%).
57105 compared with similar codes
Compare codes
57105 vs 57100 vs 57421 vs 57135 vs 56605: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57100Vaginal biopsy
- Use 57100 for a simple vaginal mucosal biopsy. Use 57105 when the documented sampling is extensive; do not select it solely because multiple fragments were submitted.
- 57421Colposcopy
- 57421 describes vaginal colposcopy with biopsy. When the biopsies are part of that colposcopy service, they are included rather than separately reported as 57105.
- 57135Vaginal lesion excision
- 57135 is for excision of a vaginal cyst or tumor. 57105 is for extensive sampling of vaginal mucosa, not removal of a cyst or tumor.
- 56605Vulvar biopsy
- 56605 applies to biopsy of vulvar or perineal tissue. 57105 applies to vaginal mucosa.
57105 billing questions
How does 57105 differ from 57100?
57105 is for extensive vaginal mucosal biopsy work; 57100 describes a simple biopsy. Document the extent and distribution of the sampled abnormal mucosa rather than relying only on the number of tissue fragments.
Can 57105 be reported with vaginal colposcopy and biopsy?
When 57421 is reported for vaginal colposcopy with biopsies, those biopsies are included in that service. Do not separately report 57105 for the same biopsy work.
Should modifier 50 be used for biopsies on both sides of the vagina?
No. The CMS bilateral adjustment does not apply to 57105, and modifier 50 is inappropriate.
Are related postoperative visits included?
Yes. Related postoperative visits during the 10-day global period are included in 57105.
What documentation supports choosing the extensive-biopsy code?
Document the abnormal mucosa's appearance and distribution, the sites sampled, and the extent of tissue collection. The record should show why the service was extensive rather than a simple vaginal mucosal biopsy.
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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