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CMS RVU26D · Effective 2026-10-01

57300 Fistula repair Medicare reimbursement rates in Washington

Reports surgical closure of a rectum-to-vagina fistula through a vaginal approach, typically for abnormal passage of stool or gas into the vagina. Compare 57300 office and facility rates across CMS payment localities in Washington.

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 57300 in Washington?

Washington 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

No supported rate

Facility setting

$567.00–$619.96

2 of 2 localities have a supported rate.

Lowest: Rest Of Washington

Highest: Seattle (King Cnty)

A spread of $52.96 per service.

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.

Find 57300 in your payment locality →

Gynecologic surgery

About 57300: Vaginal rectovaginal fistula repair

Reports surgical closure of a rectum-to-vagina fistula through a vaginal approach, typically for abnormal passage of stool or gas into the vagina.

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.

CMS billing rules for 57300

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU8.49 · 50%
  • Practice expense (office) RVU6.79 · 40%
  • Malpractice RVU1.61 · 10%

144

Medicare services in 2024 · #4598 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.

57300 compared with similar codes

Office rates for Washington, from the same CMS release.

57305

Fistula repair

Abdominal approach

No office rate

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.

57307

Fistula repair

With colostomy

No office rate

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.

57308

Fistula repair

Transperineal approach

No office rate

57308 is the related transperineal repair option; 57300 is for repair through the vaginal approach.

Compare 57300 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

Office and facility base rates · shared scale starting at $0

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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 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.

RVUs for 57300PPRRVU2026_Oct_nonQPP.csv, line 6,474 (RVU26D)