How much does Medicare pay for CPT 57156?

Medicare allowed an average of $164.67 per service and paid $130.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $688.46, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 57156?

Insertion of device into vagina for radiation therapy. It was billed 3,795 times to 1,350 Medicare beneficiaries by 89 providers in 2024.

Does 57156 pay differently in an office than a hospital?

Yes. The allowed amount averaged $216.37 in an office setting and $150.28 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 57156 most?

Radiation Oncology, with 3,795 services from 89 clinicians.

CPT 57156

Insertion of device into vagina for radiation therapy

$164.67Medicare-allowed amount per service, averaged across 3,795 services

Providers submitted

$688.46

Asking price, not received

Medicare allowed

$164.67

The fee schedule figure

Medicare paid

$130.27

Balance is patient coinsurance

Providers submitted an average of $688.46 for this code and Medicare allowed $164.67 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $130.27 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $216.37
Hospital / facility: $150.28

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 826 services were billed in an office setting and 2,969 in a facility.

Services: 3,795
Beneficiaries: 1,350
Providers billing it: 89
Total allowed: $624,923

What Medicare pays for CPT 57156

Across 3,795 services billed by 89 providers to 1,350 beneficiaries, Medicare allowed an average of $164.67 per service. That is 2.8 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 57156

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	3,795	1,350	$164.67	89

57156 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Massachusetts	426	$155.78	$113.68	8
Pennsylvania	387	$149.19	$115.05	11
New Jersey	268	$161.21	$116.76	4
Florida	249	$147.56	$115.83	5
Illinois	240	$178.41	$133.70	6
California	236	$216.86	$154.71	5
North Carolina	217	$143.89	$115.00	5
Texas	147	$175.49	$137.29	5
Indiana	137	$153.06	$114.96	2
Virginia	128	$189.70	$137.96	4
New York	126	$168.61	$116.87	2
Tennessee	106	$159.31	$132.91	3
Oklahoma	100	$139.80	$113.66	3
Arizona	99	$246.36	$179.19	1
Minnesota	91	$198.42	$153.55	3
Wisconsin	83	$140.55	$116.90	2
Washington	71	$183.84	$148.63	2
Delaware	67	$147.73	$117.70	1
Connecticut	67	$159.97	$113.95	2
Ohio	63	$148.14	$115.39	2
Kansas	63	$139.56	$117.78	1
Iowa	51	$138.97	$115.32	1
Maryland	50	$166.68	$117.66	1
Colorado	48	$151.15	$115.38	1
Montana	47	$147.64	$117.76	2
Michigan	41	$145.37	$108.67	1
Nebraska	37	$138.41	$117.75	1
Missouri	35	$130.92	$105.97	1
Oregon	33	$233.41	$180.35	1
South Carolina	29	$141.87	$115.71	1
Louisiana	28	$209.30	$179.18	1
Kentucky	25	$144.85	$117.88	1

Related codes

57160Fitting and insertion of vaginal support device$65.75
57150Irrigation of vagina and/or application of drug to treat infection$52.11
57120Suture closure of vagina and vaginal opening$299.77

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.