$127.51
Both cover colposcopy of the entire vagina, including the cervix if present. Choose 57421 when biopsy is performed; 57420 is for the examination without biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
57421 Colposcopy Medicare reimbursement rates in Wisconsin
Report this service when colposcopic examination of the entire vagina, including the cervix if present, includes directed biopsy of vaginal or cervical tissue. Compare 57421 office and facility rates across CMS payment localities in Wisconsin.
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 57421 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$168.29
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$98.53
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Gynecology
About 57421: Vaginal colposcopy with biopsy
Report this service when colposcopic examination of the entire vagina, including the cervix if present, includes directed biopsy of vaginal or cervical tissue.
A clinician uses a colposcope to inspect the entire vaginal canal and, when present, the cervix, then takes directed tissue samples from abnormal areas. Gynecologists commonly perform this in an office or outpatient facility when evaluating abnormal vaginal cytology, suspected vaginal intraepithelial lesions, or visible lesions requiring histologic assessment, including in patients who have had a hysterectomy.
Report the service when the examination covers the entire vagina and includes biopsy; the code accounts for the colposcopic examination and biopsy work. The record should identify the examined anatomy, the abnormal area sampled, and the clinical reason for sampling. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures 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. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 57421
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.15 · 39%
- Practice expense (office) RVU2.88 · 53%
- Malpractice RVU0.42 · 8%
2.3K
Medicare services in 2024 · #2362 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.
57421 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$149.14
57455 covers cervical colposcopy with biopsy. Use 57421 for colposcopic examination of the entire vagina with biopsy.
$153.53
57454 describes cervical colposcopy with biopsy and endocervical curettage; 57421 involves examination of the entire vagina with biopsy.
Compare 57421 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
$168.29
Facility
$98.53
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 57421 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,487
- Code
- 57421
- Physician work
- 2.15
- Practice expense
- 2.88
- Malpractice
- 0.42
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.15 | × 1.000 | 2.1500 |
| Practice expense | 2.88 | × 0.958 | 2.7590 |
| Malpractice | 0.42 | × 0.308 | 0.1294 |
| Total RVUs | 5.0384 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$168.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 2.88 | 0.958 |
| Malpractice | 0.42 | 0.308 |
(2.15 × 1 + 2.88 × 0.958 + 0.42 × 0.308) × $33.4009 = $168.29
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 0.7 | 0.958 |
| Malpractice | 0.42 | 0.308 |
(2.15 × 1 + 0.7 × 0.958 + 0.42 × 0.308) × $33.4009 = $98.53
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
57421 billing questions
When should 57421 be selected instead of 57420?
Use 57421 when colposcopic examination of the entire vagina includes biopsy. Code 57420 describes the corresponding examination without biopsy.
Can the biopsy be reported separately from the colposcopy?
The biopsy is included in 57421 when performed as part of the colposcopic service. Document the sampled site and the reason for biopsy.
How does 57421 differ from 57455?
57421 covers examination of the entire vagina, with the cervix if present, and biopsy. 57455 is for cervical colposcopy with biopsy, rather than the entire-vagina examination.
Should modifier 50 be appended for biopsy on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Can an assistant or co-surgeon be billed with 57421?
Medicare does not pay an assistant at surgery for this service. 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 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.
6,48457410,,Pelvic examination,A,,1.71,0.88,NA,0.88,,0.30,2.89,2.89,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48557415,,Remove vaginal foreign body,A,,2.43,1.84,NA,1.84,,0.41,4.68,4.68,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48657420,,Exam of vagina w/scope,A,,1.56,2.26,,0.57,,0.30,4.12,2.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48757421,,Exam/biopsy of vag w/scope,A,,2.15,2.88,,0.70,,0.42,5.45,3.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48857423,,Repair paravag defect lap,A,,15.68,6.23,NA,6.23,,2.67,24.58,24.58,0,090,0.08,0.83,0.09,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,48957425,,Laparoscopy surg colpopexy,A,,16.60,6.40,NA,6.40,,2.75,25.75,25.75,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,49057426,,Revise prosth vag graft lap,A,,13.94,6.96,NA,6.96,,2.33,23.23,23.23,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,