CPT 56405 Surgery - Female Genital

I&d vulva/perineal abscess Cost

Body System: Reproductive

Medicare Facility Rate
$117
CMS PFS CY2026
Medicare Non-Facility Rate
$146
Office/clinic setting
Hospital Outpatient
$311
OPPS rate
Surgery Center (ASC)
$89
ASC rate

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

1.45
Work RVU
1.79
Facility PE RVU
0.26
Malpractice RVU
4.37
Total RVU

Frequently Asked Questions

How much does I&d vulva/perineal abscess cost?

The Medicare facility rate is $117. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $311. Ambulatory surgery center rate: $89.

How much does I&d vulva/perineal abscess cost without insurance?

Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $117.

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