CPT 57107 Partial Vaginectomy Reimbursement | OpenPayer

Summary & Overview

CPT 57107: Partial Vaginectomy with Paravaginal Tissue Resection

CPT code 57107 denotes a partial vaginectomy in which the surgeon removes either the upper one third or the lower two thirds of the vagina together with paravaginal tissue. This gynecologic surgical code captures a significant operative intervention used in the management of conditions affecting vaginal and paravaginal structures and has implications for hospital, ambulatory surgery center, and payer billing and coverage policies nationwide. Nationally, accurate coding for procedures like 57107 matters for clinical reporting, resource allocation, and claims adjudication.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, typical sites of service, and the payer landscape covered. The publication outlines expected benchmarks for claims processing, common modifier usage (where provided in input), and the clinical context in which this procedure is billed. Where specific input fields are unavailable, the report notes those gaps as "Data not available in the input." The material is intended to inform coding professionals, billing staff, and policy analysts about the clinical definition, billing context, and payer coverage considerations associated with CPT code 57107.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare57107CPTgynecologysurgeryvaginectomyparavaginalhospital-surgeryambulatory-surgeryprocedure-coding

Billing Code Overview

CPT code 57107 describes a surgical procedure in which the provider removes either the upper one third or the lower two thirds of the vagina along with paravaginal tissue. This operation is a form of partial vaginectomy performed for clinical indications involving the vagina and adjacent paravaginal structures.

Service type: Major gynecologic surgical procedure (partial vaginectomy with paravaginal tissue resection)
Typical site of service: Hospital inpatient or hospital outpatient surgical setting, and ambulatory surgery centers when clinically appropriate

Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A typical patient is a postmenopausal woman presenting with symptomatic vaginal prolapse, recurrent vaginal cuff dehiscence, malignant disease involving the distal vagina, or severe vaginal scarring/stenosis unresponsive to conservative therapies. The procedure described by 57107 (removal of either the upper one third or the lower two thirds of the vagina with paravaginal tissue) is most commonly performed in an operating room under general or regional anesthesia. The clinical workflow includes preoperative evaluation (history, pelvic exam, imaging as indicated), informed consent discussing extent of resection and potential need for concurrent procedures (e.g., hysterectomy, pelvic reconstructive repairs), intraoperative resection of vaginal tissue with hemostasis and possible reconstructive steps, and postoperative monitoring for bleeding, infection, urinary function, and wound healing. Typical sites of service include an inpatient hospital operating room for more extensive resections or malignancy management, or an ambulatory surgical center for less complex, elective resections. Perioperative teams include the gynecologic surgeon, anesthesia, nursing, and pathology for specimen evaluation when indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for due to complexity, extensive adhesions, or unexpected intraoperative findings.

CPT 57109: Upper Vaginectomy with Pelvic and Para‑aortic Lymph Node Biopsy

CPT-57120-VAGINAL-CLOSURE-FOR-PROLAPSE

CPT 57120: Vaginal Closure for Vaginal Prolapse

CPT-57110-VAGINECTOMY-COMPLETE-VAGINAL-WALL-REMOVAL

CPT 57110: Complete Removal of Vaginal Wall

CPT-57130-VAGINAL-TISSUE-FLAP-REMOVAL

CPT 57130: Removal of Vaginal Tissue Flap

CPT-57105-VAGINAL-LESION-BIOPSY-LARGE-LESION

CPT 57105: Evaluation and Biopsy of Large Vaginal Lesion

CPT-57106-PARTIAL-VAGINECTOMY-UPPER-OR-LOWER-RESECTION

CPT 57106: Partial Vaginectomy, Upper One-Third or Lower Two-Thirds

CPT-57135-VAGINAL-WALL-CYST-TUMOR-EXCISION

CPT 57135: Excision of Vaginal Wall Cyst or Tumor

CPT-57100-VAGINAL-MUCOSAL-LESION-BIOPSY

CPT 57100: Biopsy of Lesion on Vaginal Mucosa

CPT-57111-VAGINECTOMY-WITH-PARAVAGINAL-TISSUE-REMOVAL

CPT 57111: Vaginectomy with Paravaginal Tissue Removal

57107

Taxonomy Code	Specialty	Notes
`208M00000X`	Obstetrics & Gynecology	Most common specialty performing `57107`.
`2080P0206X`	Gynecologic Oncology	Common when resection is performed for vaginal or paravaginal malignancy.
`207RG0300X`	Female Pelvic Medicine & Reconstructive Surgery (Urogynecology)	Common when procedure is part of prolapse or reconstructive surgery.
`2084P0802X`	General Surgery	May be involved for extensive pelvic resections or multidisciplinary cases.
`206E00000X`	Anesthesiology	Provides perioperative anesthesia care for the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N81.3`	Prolapse of vaginal vault	Pelvic organ prolapse can necessitate partial vaginectomy when vault prolapse is severe or recurrent.
`C52`	Malignant neoplasm of vagina	Primary malignant vaginal tumors may require partial vaginectomy with paravaginal tissue removal.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Cervical cancer with extension into the upper vagina may require resection of vaginal tissue.
`N99.8`	Other postprocedural disorders of genitourinary system	Used for complications after prior pelvic surgery leading to need for resection.
`N90.89`	Other atrophy of vagina and vulva	Severe scarring or stenosis from atrophy or prior radiation can lead to symptomatic disease requiring resection.
`T81.4XXA`	Infection following a procedure, initial encounter	Postoperative or postprocedural infection involving the vagina that may require surgical management.
`K66.89`	Other specified disorders of peritoneum	When paravaginal involvement extends into peritoneal spaces; used in complex pelvic disease contexts.
`D49.2`	Neoplasm of uncertain behavior of female genital organs	Lesions of uncertain behavior in the vagina may prompt partial vaginectomy for diagnosis and treatment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57558`	Total vaginectomy (removal of entire vagina)	Performed when disease extent requires removal of the entire vaginal canal instead of the partial resection described by `57107`.
`57110`	Vaginectomy, up to one third, with repair (simple)	A less extensive partial vaginectomy that may be performed for more limited disease; may be chosen instead of `57107` based on extent.
`57220`	Anterior colporrhaphy (repair of cystocele)	May be performed concurrently when prolapse involves anterior vaginal wall or paravaginal support.
`57288`	Sling operation for stress incontinence (e.g., midurethral sling)	May be performed before or after resection to address concurrent stress urinary incontinence.
`57425`	Colposcopy of the cervix including upper vagina; with biopsy(s)	Performed preoperatively to evaluate mucosal lesions that may affect the extent of resection.
`88305`	Surgical pathology, gross and microscopic examination	Used for specimen pathology evaluation when tissue removed during `57107` is sent to pathology.

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