Summary & Overview
CPT 56810: Repair of Perineum
CPT code 56810 represents a surgical repair of the perineum, a commonly billed gynecologic procedure to correct trauma or tissue disruption in the perineal region. Nationally, this code is used across hospital outpatient departments, ambulatory surgical centers, and in some operative settings where repair of perineal tissue is required. Accurate coding for 56810 matters for clinical documentation, surgical quality reporting, and correct claim adjudication.
Payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The coverage landscape spans commercial and government payers that commonly process surgical and obstetric-gynecologic procedure claims.
Readers will learn the clinical context for using 56810, the typical sites of service, and what to expect in terms of payer mix and billing considerations. The report also provides benchmark-oriented content on utilization patterns, common modifiers used with surgical repairs, and documentation elements that support medical necessity. Where specific data elements were not provided, the publication notes that those items are not available in the input.
This national-level overview is intended for coding professionals, billing staff, and clinicians involved in operative gynecologic care who need concise information about the purpose and typical use of CPT code 56810.
Billing Code Overview
CPT code 56810 describes a surgical repair of the perineum, performed to correct damage to the perineal tissues. The procedure involves direct repair of the perineal body and surrounding soft tissues to restore anatomy and function.
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Service type: Surgical repair (perineal repair)
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Typical site of service: Operating room, ambulatory surgical center, or procedure suite depending on clinical context and anesthesia needs.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 28-year-old female presents to the labor and delivery unit after a spontaneous vaginal delivery with a second-degree perineal laceration involving the vaginal mucosa and underlying perineal muscle. The obstetrician evaluates the wound immediately postpartum, administers local anesthesia, irrigates and debrides devitalized tissue as needed, and performs layered closure of the vaginal mucosa and perineal muscles with absorbable sutures to restore anatomy and hemostasis. Typical workflow includes pre-procedure consent and verification, analgesia (local or regional already in place), procedural time-out, layered repair in the delivery room or procedure suite, documentation of laceration degree and repair technique, post-procedure wound care instructions, and follow-up in the postpartum clinic.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds usual for a standard perineal repair. |
23 | Unusual anesthesia service | Use when general anesthesia is medically necessary for the repair.
26 | Professional component | Use when billing only the physician component of a split-bill service (rare for this procedure).