CPT 56632 Radical Vulvectomy Reimbursement | OpenPayer

Summary & Overview

CPT 56632: Radical Vulvectomy with Bilateral Inguinofemoral Lymph Node Dissection

CPT code 56632 denotes a radical vulvectomy, a major oncologic gynecologic surgery that removes vulvar tissue adjacent to malignancy and typically includes bilateral inguinofemoral lymph node dissection. This procedure matters nationally because it addresses invasive vulvar cancers that require extensive resection and regional nodal staging or clearance, with implications for surgical morbidity, reconstruction needs, and postoperative care pathways. Payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing overview of CPT code 56632, including its service type and typical site of service, common payer coverage landscape, and areas where policy and billing practices affect utilization and claim adjudication. The publication summarizes benchmarks and reimbursement context where available, outlines relevant clinical context for coding and documentation, and highlights policy updates or payer-specific considerations when present. Data not available in the input will be identified as such rather than inferred.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 56632radical vulvectomygynecologic oncologysurgical oncologylymph node dissectioninpatient surgeryvulvar canceroperating room

Billing Code Overview

CPT code 56632 describes a radical vulvectomy performed for malignant disease of the vulva. The procedure involves wide excision of vulvar tissue surrounding the malignancy and commonly includes removal of bilateral inguinofemoral lymph nodes; removal of the clitoris may occur depending on disease extent. This is a radical oncologic surgical procedure aimed at local control of vulvar cancer.

Service Type: Radical oncologic gynecologic surgery

Typical Site of Service: Inpatient surgical suite or hospital operating room with possible inpatient recovery

Clinical & Coding Specifications

Clinical Context

A typical patient is a postmenopausal woman presenting with a biopsy-proven squamous cell carcinoma of the vulva with clinical or radiographic evidence suggesting regional nodal involvement. Preoperative workup includes history and physical, pelvic exam, imaging (pelvic MRI or CT, and PET/CT as indicated), and anesthesia evaluation. The multidisciplinary team (gynecologic oncology, surgical oncology, radiation oncology as needed) discusses extent of resection. On the day of surgery the patient undergoes a radical vulvectomy under general anesthesia with removal of the primary vulvar tumor and wide margins, and bilateral inguinofemoral lymphadenectomy. Intraoperative steps include tumor localization, incision and en bloc resection of involved vulvar tissue (which may include partial or complete clitoridectomy depending on tumor extent), hemostasis, bilateral groin dissection for inguinofemoral nodes, assessment for reconstruction (primary closure, skin graft, or flap), and placement of drains as needed. Postoperative care includes monitoring in PACU, wound and drain management, pain control, venous thromboembolism prophylaxis, and coordination for pathology review and adjuvant therapy planning if margins or nodes are positive. Typical site of service is an inpatient surgical setting at an acute care hospital or an ambulatory surgery center with capabilities for extended recovery if limited resection is performed and patient meets outpatient criteria.

Coding Specifications

Modifier	Description	When to Use
`00`	Exempt companion code (institution-specific)

CPT 56740: Surgical Treatment for Bartholin’s Gland Abscess or Cyst

CPT-56606-EXCISION-VULVA-PERINEUM-ADDITIONAL-LESIONS

CPT 56606: Excision of Suspicious Vulvar or Perineal Lesions

CPT-56633-RADICAL-VULVECTOMY-SURGICAL-ONCOLOGY

CPT 56633: Radical Vulvectomy for Malignant Disease

CPT-56620-SIMPLE-VULVECTOMY-GYNECOLOGIC-EXCISION

CPT 56620: Simple Vulvectomy for Benign or Premalignant Vulvar Conditions

CPT-56634-RADICAL-VULVECTOMY-INGUINOFEMORAL-LYMPH-NODE

CPT 56634: Radical Vulvectomy with Unilateral Inguinofemoral Lymph Node Removal

CPT-56630-RADICAL-VULVECTOMY-MAJOR-ONCOLOGIC-SURGERY

CPT 56630: Radical Vulvectomy for Malignant Disease

CPT-56637-RADICAL-VULVECTOMY-WITH-BILATERAL-LYMPHADENECTOMY

CPT 56637: Radical Vulvectomy with Bilateral Inguinofemoral Lymphadenectomy

CPT-56640-RADICAL-VULVECTOMY-WITH-LYMPHADENECTOMY

CPT 56640: Radical Vulvectomy with Regional Lymphadenectomy

CPT-56631-RADICAL-VULVECTOMY-UNILATERAL-INGUINOFEMORAL-NODE

CPT 56631: Radical Vulvectomy with Unilateral Inguinofemoral Node Removal

CPT-56700-HYMENOTOMY-HYMENAL-REVISION

CPT 56700: Hymenotomy and Hymenal Ring Revision

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Taxonomy Code	Specialty	Notes
`207V00000X`	Gynecologic Oncology	Primary specialty performing radical vulvectomy and inguinofemoral lymphadenectomy.
`2080P0207X`	General Surgery	May perform extensive oncologic vulvar resections and groin dissections in some centers.
`207RC0000X`	Obstetrics & Gynecology	Gynecologic surgeons may perform the procedure when subspecialty care not required.
`207K00000X`	Surgical Oncology	Surgical oncologists involved in multidisciplinary management and complex resections.
`363LF0000X`	Plastic Surgery	Performs reconstruction (flaps, grafts) when complex closure or reconstruction is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C51.1`	Malignant neoplasm of labium majus	Common primary diagnosis indicating vulvar cancer treated with radical vulvectomy.
`C51.2`	Malignant neoplasm of clitoris	Tumors involving the clitoris may necessitate partial or complete clitoridectomy as part of radical vulvectomy.
`C51.9`	Malignant neoplasm of vulva, unspecified	Used when vulvar malignancy is documented without further anatomic specificity.
`C79.82`	Secondary malignant neoplasm of genital organs	May be used when vulvar disease represents metastasis from another primary site or when regional spread is documented.
`D07.1`	Carcinoma in situ of vulva	When extensive pre-invasive disease requires radical excision in select cases or when margins are uncertain.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19318`	Breast reconstruction, immediate or delayed (implant or flap) — (example reconstructive code)	Performed when patients require complex flap reconstruction; plastic surgery codes for closure may be billed in conjunction when documented and distinct.
`12032`	Repair secondary intention or scar revision, intermediate (e.g., complex vulvar wound closure)	Used for partial closures or wound revisions following initial resection if coded separately.
`38746`	Lymphadenectomy, inguinal, unilateral (separate node dissection code)	Related for documentation of groin node dissection; `56632` includes bilateral inguinofemoral node removal, but isolated or staged nodal procedures may use node-specific codes.
`15734`	Muscle, myocutaneous or fasciocutaneous flap for reconstruction	Used when flap reconstruction of the vulva/perineum is performed after radical vulvectomy.
`49020`	Removal of implanted material, e.g., drains (example postoperative procedure)	Commonly used for drain removal or related minor procedures during the postoperative period.

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