Billing code 57311: Fistula repairMedicare rate & RVUs in Utah
Reports abdominal repair of a urethrovaginal fistula, an abnormal connection between the urethra and vagina that causes urine to leak into the vagina.
CMS doesn’t publish an office rate for 57311 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 57311 covers
This service repairs a fistula connecting the urethra with the vagina through an abdominal surgical approach. The defect can cause continuous or persistent urinary leakage into the vagina. A urologist, urogynecologist, or gynecologic surgeon typically performs the repair in a hospital or other facility. The operative report should identify the urethrovaginal tract and show that the abdominal route was used; the vaginal-route repair is a different code.
Report one unit for the repair and support the code with the fistula anatomy, operative approach, and work performed. This major surgery 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 50% reduction. Modifier 50 is not appropriate. Assistant-at-surgery services may be paid; co-surgeons require 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.
57311 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $489.62 |
How the 57311 rate is calculated
Each of 57311’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 · 57311
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.69Practice expense 5.28Malpractice 1.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57311
57311 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57311
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 · 57311
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
57311 without 51 · national facility
$504.02
Fistula repair
57311-51 · Second procedure: 50%
$252.01
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%).
57311 compared with similar codes
Compare codes
57311 vs 57310 vs 57320 vs 57330: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57310Fistula repair
- Use 57311 when the fistula repair is performed through an abdominal approach; 57310 is for the vaginal approach.
- 57320Fistula repair
- This code addresses a fistula between the bladder and vagina through a vaginal approach. Code 57311 is for a urethra-to-vagina fistula repaired abdominally.
- 57330Fistula repair
- This code addresses a bladder-to-vagina fistula repaired abdominally. Choose 57311 when the fistula instead connects the urethra and vagina.
57311 billing questions
How does this differ from 57310?
Both codes address a urethrovaginal fistula, but 57311 is for repair through an abdominal approach. Code 57310 describes the vaginal approach.
What documentation supports reporting 57311?
Document the connection between the urethra and vagina, the abdominal route used, and the operative repair performed. The record should make clear that this was not a vaginal-route repair.
Can modifier 50 be used?
No. A bilateral adjustment is not appropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction. Related postoperative care is included in the 90-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is 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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