CPT 57240 Anterior Colporrhaphy Reimbursement | OpenPayer

Summary & Overview

CPT 57240: Anterior Vaginal Wall Repair (Cystocele)

CPT code 57240 denotes an anterior colporrhaphy: surgical repair of the anterior vaginal wall to correct a cystocele, often performed via transvaginal approach and sometimes accompanied by urethrocele repair or cystourethroscopy. This procedure is a common pelvic reconstructive surgery and is clinically important because it addresses symptomatic bladder prolapse that can affect quality of life and urinary function. Nationally, procedures for pelvic organ prolapse are a routine component of gynecologic and urologic surgical care.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service (hospital inpatient, hospital outpatient department, and ambulatory surgery centers), and the procedural scope implied by the code description. The publication summarizes billing implications, common modifier usage patterns provided in the input, and places the code in clinical context for procedural planning and coding accuracy.

This summary is intended for a national audience of coding professionals, clinicians, and payers seeking a clear reference for CPT code 57240, including benchmarks and policy-relevant considerations where available. Data not available in the input will be noted in the relevant sections of the full publication.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare57240CPTanterior colporrhaphypelvic reconstructive surgerycystoceletransvaginal repairgynecologysurgical procedureambulatory surgery

Billing Code Overview

CPT code 57240 describes a surgical repair of the anterior vaginal wall to correct a cystocele (prolapsed bladder) using a vaginal approach. The procedure may include repair of a urethrocele and may be accompanied by cystourethroscopy, an endoscopic examination of the bladder.

Service type: Surgical repair of pelvic organ prolapse (anterior vaginal wall repair).
Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgery center using a transvaginal surgical approach.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a postmenopausal woman presenting with symptomatic anterior vaginal wall bulge, urinary pressure, or incomplete bladder emptying. Clinical evaluation includes pelvic exam confirming cystocele (anterior vaginal wall prolapse), urogynecologic history, and preoperative testing such as urinalysis and, if indicated, urodynamics. The provider plans a transvaginal anterior colporrhaphy (57240) to repair the anterior vaginal wall and reduce the prolapsing bladder. Intraoperative steps typically include vaginal anesthesia or general anesthesia, incision of the anterior vaginal epithelium, dissection to expose the pubocervical fascia/defect, plication or repair of fascial support, and layered closure of the vaginal mucosa. A urethrocele repair may be performed concurrently if urethral support is deficient; cystourethroscopy can be performed intraoperatively to inspect the bladder and ureters for injury or pathology. Postoperative workflow includes monitoring for urinary retention, management of pain and infection prophylaxis, voiding trials, and follow-up pelvic exam to assess repair integrity and wound healing.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity of `57240` substantially exceeds typical for the procedure.

CPT 57250: Posterior Vaginal Wall Repair (Rectocele) with Perineal Repair

CPT-57291-VAGINOPLASTY-WITHOUT-GRAFT-VAGINAL-AGENESIS

CPT 57291: Construction of Artificial Vagina without Graft

CPT-57265-VAGINAL-REPAIR-PELVIC-ORGAN-PROLAPSE-ENTEROCELE

CPT 57265: Vaginal Repair of Pelvic Organ Prolapse with Enterocele

CPT-57210-VAGINAL-PERINEAL-LACERATION-REPAIR-NONOBSTETRIC

CPT 57210: Repair of Vaginal Wall or Perineal Laceration, Nonobstetric

CPT-57283-VAGINAL-VAULT-SUSPENSION-VAGINAL-APPROACH

CPT 57283: Vaginal Vault Suspension via Vaginal Approach

CPT-57310-URETHROVAGINAL-FISTULA-REPAIR-VAGINAL-APPROACH

CPT 57310: Urethrovaginal Fistula Repair, Vaginal Approach

CPT-57287-SLING-REMOVAL-UNDER-URETHRA

CPT 57287: Removal of Urethral Sling for Stress Urinary Incontinence

CPT-57200-VAGINAL-WALL-LACERATION-REPAIR

CPT 57200: Repair of Nonobstetric Vaginal Wall Laceration

CPT-57305-ABDOMINAL-EXCISION-RECTOVAGINAL-FISTULA

CPT 57305: Abdominal Excision of Rectovaginal Fistula

CPT-57330-VESICOVAGINAL-FISTULA-REPAIR-ABDOMINAL-AND-VAGINAL-APPROACH

CPT 57330: Vesicovaginal Fistula Repair, Combined Abdominal and Vaginal Approach

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Taxonomy Code	Specialty	Notes
`168P00000X`	Obstetrics & Gynecology	Most common specialty performing anterior colporrhaphy.
`207L00000X`	Urology	Urologists perform repairs when complex bladder or urethral involvement is present.
`207RX0400X`	Female Pelvic Medicine & Reconstructive Surgery (FPMRS)	Subspecialists who frequently perform `57240` and manage complex prolapse.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N81.11`	Cystocele, midline	Represents anterior vaginal wall prolapse (cystocele) commonly treated with `57240`.
`N81.12`	Cystocele, lateral	Lateral defects of the anterior vaginal wall addressed during anterior colporrhaphy.
`N81.2`	Urethrocele	Often coexists with cystocele; a urethrocele repair may be performed with `57240`.
`N39.3`	Stress incontinence (female)	May coexist with anterior prolapse; often prompts concurrent anti-incontinence procedures.
`R32`	Unspecified urinary retention	Post-voiding symptoms or voiding dysfunction may be evaluated pre- or postoperatively in patients undergoing `57240`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57425`	Cystourethroscopy, with or without irrigation, instillation, or ureteral catheterization; diagnostic, with or without collection of specimen(s) by brushing or washing	Performed intraoperatively or separately to inspect the bladder and urethra during or after `57240` when indicated.
`57250`	Colpopexy, abdominal approach (sacrocolpopexy)	Alternative or additional prolapse repair approach when vaginal repair (`57240`) is not appropriate or when apical support is required.
`57260`	Vaginal colpopexy, other than sacral colpopexy (includes use of mesh)	May be performed adjunctively for apical support during comprehensive pelvic reconstructive surgery including anterior repair.
`51990`	Repair with graft or sling for urethral support (urethropexy)	Performed when there is concurrent stress urinary incontinence or urethral hypermobility requiring anti-incontinence procedure along with `57240`.
`52204`	Cystourethroscopy, with ureteroscopy not performed; with biopsy, single or multiple	Performed when bladder pathology is suspected and tissue sampling is required during evaluation with or around the time of `57240`.

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