Billing code 57170: Diaphragm fittingMedicare rate & RVUs in Washington
Report this service when a clinician selects and assesses the fit of a contraceptive diaphragm or cervical cap for a patient.
Medicare pays $73.92–$81.89 for 57170 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 57170 covers
A clinician fits a contraceptive diaphragm or cervical cap by selecting an appropriate device size and assessing how it sits in the vagina. The service is typically performed in an office gynecology or family-planning visit. The fitting is distinct from placing a pessary for pelvic support or inserting an intrauterine device. Documentation should identify the barrier device fitted, the fitting assessment, and any relevant instruction provided to the patient.
Report 57170 for the fitting service, not for a general contraception discussion alone. The record should support that a diaphragm or cap was actually assessed for fit. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is 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. Assistant-at-surgery payment requires documented medical necessity; 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.
Where 57170 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $73.92 | $40.86 |
| Seattle (King Cnty) | $81.89 | $43.37 |
How the 57170 rate is calculated
Each of 57170’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 · 57170
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.89Practice expense 1.13Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57170
The CMS indicators that decide how 57170 is paid alongside other services.
CMS payment indicators · 57170
Diaphragm fitting
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
57170 without 51 · national office
$72.81
Diaphragm fitting
57170-51 · Second procedure: 50%
$36.41
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%).
57170 compared with similar codes
Compare codes
57170 vs 57160 vs 58300 vs 99401: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57160Pessary fitting
- Use 57170 for fitting a contraceptive diaphragm or cervical cap. Use 57160 for insertion of a pessary or another vaginal device, typically for pelvic support.
- 58300Insert intrauterine device
- Code 58300 reports IUD insertion. It is a different contraceptive method, not a diaphragm or cervical-cap fitting.
- 99401Prev med cnsl indiv apprx 15
- Code 99401 describes individual preventive counseling. It is not a substitute for 57170 when a diaphragm or cap is actually fitted.
57170 billing questions
How is 57170 different from 57160?
57170 is for fitting a contraceptive diaphragm or cervical cap. Code 57160 concerns insertion of a pessary or another device, commonly for pelvic support.
Does a contraception discussion alone support 57170?
No. The record should show that a diaphragm or cap was fitted and that its fit was assessed; discussion without fitting is not this service.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What happens when another procedure is performed in the same session?
CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
What are the assistant and surgical-team payment rules?
Assistant-at-surgery payment requires documentation of medical necessity. 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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