Summary & Overview
CPT 56740: Surgical Treatment for Bartholin’s Gland Abscess or Cyst
CPT code 56740 identifies a surgical procedure for persistent or recurrent Bartholin’s gland abscesses or cysts. This code denotes a targeted gynecologic procedure with implications for ambulatory surgical care and outpatient facility utilization nationwide. It matters because management of recurrent Bartholin pathology affects surgical resource use, ambulatory surgery scheduling, and payer coverage policies.
Key payers commonly involved in coverage and claims for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on clinical context, common settings of care, and what stakeholders typically review when evaluating claims for this service.
Readers will learn the clinical purpose of the code, typical sites of service, and the areas usually considered in reimbursement and utilization reviews. Where available, the report includes benchmarks and policy elements relevant to this procedure, summarizes common billing considerations, and outlines the clinical scenarios that typically generate use of CPT code 56740. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 56740 describes a surgical procedure performed for persistent and recurrent Bartholin’s gland abscesses or cysts. The service involves incision and drainage with or without excision of the Bartholin gland as indicated by the clinical scenario.
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Service type: Surgical treatment of Bartholin’s gland abscess or cyst
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Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be performed in an office setting depending on clinical circumstances and facility capability.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28-year-old woman presenting to a gynecology clinic with a 3-week history of a painful, fluctuant mass at the left vulvar vestibule that intermittently drains and recurs despite two courses of oral antibiotics. Physical exam shows a tender, ~2 cm posterior labial mass consistent with a Bartholin gland abscess. The clinician discusses treatment options and schedules an in-office procedure under local anesthesia for marsupialization of the Bartholin gland. The workflow includes informed consent, pre-procedure photography and time-out, local infiltration with lidocaine, incision and drainage with creation of a marsupialization stoma, hemostasis, and instructions for sitz baths and wound care. The procedure may be billed with 56740 when performed for persistent or recurrent Bartholin gland cysts or abscesses. Typical site of service is an outpatient clinic, ambulatory surgery center, or same-day surgical unit. Common peri-procedural documentation includes indication, prior treatments, operative technique, estimated blood loss (usually minimal), anesthesia type (local with or without sedation), specimen disposition if obtained, and post-procedure instructions and follow-up plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for and well documented. |