56605

Active0-day global

Biopsy of vulva/perineum

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.

Locality

or ZIP

Show values as

Modifiers

Line	Qty	Non-facility (office)	Facility (hospital/ASC)
56605Biopsy of vulva/perineum	1	$93.52	$51.77
add-on56606Biopsy of vulva/perineum	0	$39.08/ unit	$25.38/ unit

Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCI_w + PE×GPCI_pe + MP×GPCI_mp) × CF

Row	Work RVU	PE RVU (office)	PE RVU (facility)	MP RVU	Total (office)
56605	1.07	1.54	0.29	0.19	2.80

Payment policy for 56605

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=2

Standard MPPR

When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=1

Not payable

Assistant at surgery may not be paid for this procedure.

Co-surgeons (modifier 62)

co_surg=2

Payable

Co-surgeons (mod 62) are paid 62.5% of the fee each (125% total, split).

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.