Home / Medicare fees / 57267

57267 Insert mesh/pelvic flr addon

What 57267 is

CMS fee schedule short descriptor: Insert mesh/pelvic flr addon.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 57267 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)4.761.020.786.56$219.11
Facility (hospital, ASC)4.761.020.786.56$219.11

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 57267 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 57267? These codes are bundled into it

57267 is a Column 1 code in 23 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0437TImpltj synth rnfcmt abdl wal1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
15777Acellular derm matrix implt1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
56810Perineoplasty rpr per nonob0 - no modifier bypassCheck pair
57000Colpotomy w/exploration0 - no modifier bypassCheck pair
57100Biopsy vaginal mucosa simple0 - no modifier bypassCheck pair
57105Biopsy vaginal mucosa xtnsv1 - modifier may bypassCheck pair
57150Treat vagina infection0 - no modifier bypassCheck pair
57180Treat vaginal bleeding0 - no modifier bypassCheck pair
57210Repair vagina/perineum1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
97597Dbrdmt opn wnd 1st 20 cm/<1 - modifier may bypassCheck pair
97598Dbrdmt opn wnd addl 20cm/<1 - modifier may bypassCheck pair
97602Wound(s) care non-selective1 - modifier may bypassCheck pair

57267 is bundled into these codes

57267 appears as a Column 2 code in 63 active edits. Reported with one of these Column 1 codes on the same date of service, 57267 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11004Dbrdmt skin xtrnl gent&per1Check pair
11005Dbrdmt skin abdominal wall1Check pair
11006Dbrdmt skin xtrnl gent per1Check pair
32800Repair lung hernia1Check pair
39503Repair of diaphragm hernia1Check pair
39540Repair of diaphragm hernia1Check pair
39541Repair of diaphragm hernia1Check pair
43281Lap paraesophag hern repair1Check pair
43282Lap paraesoph her rpr w/mesh1Check pair
43332Transab esoph hiat hern rpr1Check pair
43333Transab esoph hiat hern rpr1Check pair
43334Transthor diaphrag hern rpr1Check pair
43335Transthor diaphrag hern rpr1Check pair
43336Thorabd diaphr hern repair1Check pair
43337Thorabd diaphr hern repair1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.