$389.31–$446.43
Choose 57156 for insertion of a vaginal afterloading apparatus such as a vaginal cylinder. Choose 57155 when the applicator placement involves a uterine tandem and/or vaginal ovoids.
On this page
CMS RVU26D · Effective 2026-10-01
57156 Brachytherapy insertion Medicare reimbursement rates in Virginia
Report this service when a clinician inserts a vaginal afterloading applicator to prepare for intracavitary brachytherapy, such as treatment of a vaginal cuff. Compare 57156 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 57156 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$219.53–$252.31
2 of 2 localities have a supported rate.
Facility setting
$124.31–$138.21
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiation oncology
About 57156: Vaginal brachytherapy applicator insertion
Report this service when a clinician inserts a vaginal afterloading applicator to prepare for intracavitary brachytherapy, such as treatment of a vaginal cuff.
A radiation oncologist or gynecologic oncologist places an afterloading applicator in the vagina to prepare for intracavitary brachytherapy. A vaginal cylinder is a common example, including for treatment directed to the vaginal cuff after hysterectomy for endometrial cancer. The service involves positioning the applicator for the planned treatment, rather than excision or treatment of a vaginal lesion.
Report the insertion when the record supports placement of a vaginal brachytherapy apparatus; document the indication and the applicator placed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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 inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted. Radiation delivery is a distinct service when performed and may be reported separately with the applicable delivery code.
CMS billing rules for 57156
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.62 · 39%
- Practice expense (office) RVU3.87 · 58%
- Malpractice RVU0.21 · 3%
14.5K
Medicare services in 2024 · #1271 by national volume
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.
57156 compared with similar codes
Office rates for Virginia, from the same CMS release.
$68.38–$79.09
57160 is for fitting and inserting a pessary or other vaginal support device. It is not the code for placing an applicator to prepare for brachytherapy.
Compare 57156 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$252.31
Facility
$138.21
Virginia →
Office / nonfacility
$219.53
Facility
$124.31
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57156 billing questions
How does this differ from 57155?
57156 is for placing a vaginal afterloading apparatus, commonly a vaginal cylinder. 57155 describes placement of a uterine tandem and/or vaginal ovoids for brachytherapy.
Does this code include radiation delivery?
It reports applicator insertion, not the radiation delivery itself. Report a separately performed delivery service with the applicable brachytherapy delivery code.
Is modifier 50 appropriate when treatment is directed to both sides?
No. CMS identifies bilateral adjustment as inappropriate for this service, so do not use modifier 50.
What documentation supports reporting 57156?
Document the brachytherapy indication, the vaginal afterloading apparatus placed, and the placement performed. The record should distinguish this service from placement of a uterine tandem or vaginal ovoids.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,44457135,,Excision vaginal cyst/tumor,A,,2.63,4.19,,1.95,,0.46,7.28,5.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44557150,,Treat vagina infection,A,,0.49,1.03,,0.11,,0.07,1.59,0.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44657155,,Insert uteri tandem/ovoids,A,,5.02,6.42,,1.66,,0.46,11.90,7.14,0,000,0.00,0.00,0.00,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44757156,,Ins vag brachytx device,A,,2.62,3.87,,0.97,,0.21,6.70,3.80,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44857160,,Insert pessary/other device,A,,0.87,1.09,,0.19,,0.15,2.11,1.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,44957170,,Fitting of diaphragm/cap,A,,0.89,1.13,,0.19,,0.16,2.18,1.24,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45057180,,Treat vaginal bleeding,A,,1.59,3.80,,1.34,,0.27,5.66,3.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00