# CPT 57170: Diaphragm/cervical Cap Fitting W/instructions

Medicare CPT 57170 pays $72.81 in a non-facility setting and $41.42 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $64.90 in Arkansas to $87.73 in Alaska, a 35% spread.

Web page: https://www.med-reveal.com/rates/57170-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Obstetrics & Gynecology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $72.81 |
| National facility | $41.42 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $87.73 | $54.29 |
| District of Columbia | $81.74 | $44.76 |
| New York | $80.51 | $45.48 |
| New Jersey | $79.54 | $44.19 |
| California | $78.35 | $41.20 |
| Florida | $78.00 | $46.50 |
| Washington | $77.91 | $42.11 |
| Massachusetts | $77.49 | $42.21 |
| Connecticut | $77.44 | $43.62 |
| Illinois | $76.51 | $46.18 |
| Hawaii | $75.73 | $40.04 |
| Maryland | $75.22 | $42.49 |
| Colorado | $74.42 | $41.01 |
| Rhode Island | $74.05 | $41.61 |
| New Hampshire | $73.69 | $41.01 |
| Oregon | $73.60 | $40.52 |
| Puerto Rico | $73.15 | $41.41 |
| Virgin Islands | $73.15 | $41.41 |
| Montana | $72.80 | $41.41 |
| Michigan | $72.69 | $43.21 |
| Pennsylvania | $72.68 | $41.92 |
| Georgia | $72.17 | $42.22 |
| Texas | $72.01 | $41.10 |
| Delaware | $71.97 | $40.95 |
| Nevada | $71.96 | $40.53 |
| Wyoming | $71.42 | $40.03 |
| Arizona | $70.87 | $40.45 |
| New Mexico | $70.76 | $41.96 |
| Virginia | $70.60 | $39.74 |
| West Virginia | $70.17 | $42.89 |
| Minnesota | $70.15 | $37.84 |
| Utah | $70.00 | $40.49 |
| Vermont | $69.80 | $38.71 |
| Louisiana | $69.78 | $41.12 |
| North Dakota | $69.64 | $38.24 |
| Missouri | $69.62 | $40.81 |
| Ohio | $69.57 | $40.91 |
| South Dakota | $69.27 | $37.87 |
| South Carolina | $69.14 | $40.13 |
| Maine | $69.13 | $39.14 |
| North Carolina | $68.36 | $39.06 |
| Kentucky | $68.17 | $40.26 |
| Oklahoma | $67.58 | $39.55 |
| Wisconsin | $67.53 | $37.45 |
| Indiana | $67.31 | $38.21 |
| Idaho | $66.98 | $38.09 |
| Tennessee | $66.91 | $38.37 |
| Nebraska | $66.58 | $37.60 |
| Kansas | $66.54 | $38.16 |
| Iowa | $66.38 | $37.66 |
| Mississippi | $66.17 | $39.14 |
| Alabama | $65.78 | $38.30 |
| Arkansas | $64.90 | $37.93 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 57170 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules