Billing code 57300: Fistula repairMedicare rate & RVUs in Utah
Reports surgical closure of a rectum-to-vagina fistula through a vaginal approach, typically for abnormal passage of stool or gas into the vagina.
CMS doesn’t publish an office rate for 57300 in Utah.
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 57300 covers
A rectovaginal fistula is an abnormal connection between the rectum and vagina that can allow stool or gas to pass through the vagina. This service repairs the tract through the vaginal route, with closure of the involved tissue. Gynecologic or colorectal surgeons may perform the repair in an operating room, often for a fistula related to childbirth, prior surgery, or disease affecting the tissues.
Select 57300 when the documented repair uses the vaginal approach; the operative report should identify the fistula and describe the route and repair performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
57300 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $545.05 |
How the 57300 rate is calculated
Each of 57300’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 · 57300
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.49Practice expense 6.79Malpractice 1.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57300
57300 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57300
Fistula repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57300
Fistula repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57300 without 51 · national facility
$564.14
Fistula repair
57300-51 · Second procedure: 50%
$282.07
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%).
57300 compared with similar codes
Compare codes
57300 vs 57305 vs 57307 vs 57308: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57305Fistula repair
- Both codes concern rectovaginal fistula repair. Choose 57300 when the operative report documents the vaginal approach; use the sibling code when its approach matches the procedure performed.
- 57307Fistula repair
- This is a related rectovaginal fistula repair code associated with colostomy. Match the reported code to the operation documented, rather than treating the codes as interchangeable.
- 57308Fistula repair
- 57308 is the related transperineal repair option; 57300 is for repair through the vaginal approach.
57300 billing questions
When should 57300 be selected over another rectovaginal fistula repair code?
Use 57300 when the operative report documents a vaginal approach. Select a sibling code when the actual approach or associated procedure matches that code’s descriptor.
Does 57300 describe repair of a urethrovaginal or bladder-vaginal fistula?
No. It concerns a connection between the rectum and vagina; urethral or bladder connections involve different anatomy and code families.
What documentation supports reporting 57300?
Document the rectovaginal fistula, the vaginal route, and the repair performed. The operative report should make the anatomy and approach clear.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
Can an assistant or co-surgeon be reported for 57300?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
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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