Summary & Overview
CPT 57270: Abdominal Repair of Vaginal Wall for Small Bowel Prolapse
CPT code 57270 denotes an abdominal approach repair of the vaginal wall (Halban or Moschowitz repair) performed to correct small bowel prolapse into the vaginal canal (enterocele). Nationally, this operative gynecologic code is relevant for surgical case mix, facility resource planning, and payer coverage policies for complex pelvic reconstructive procedures. It captures an abdominal pelvic surgical service distinct from purely vaginal repairs and from minimally invasive approaches.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure, common sites of service, and typical surgical setting. The publication also outlines benchmarking considerations, billing and coding implications, and policy or coverage themes that affect reimbursement and utilization nationally. Where specific payer policy detail is unavailable, the summary notes Data not available in the input.
This report is intended to inform administrators, coding professionals, and policy analysts about the clinical intent of CPT code 57270, how it is classified for billing and operational purposes, and the types of topics—benchmarks, coverage nuances, and coding context—covered in the full analysis.
Billing Code Overview
CPT code 57270 describes a surgical repair of the vaginal wall using an abdominal approach to address small bowel prolapse into the vaginal canal. The procedure names referenced include the Halban or Moschowitz repair techniques, which are used to reconstitute and reinforce the vaginal wall over the area of enterocele.
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Service type: Abdominal pelvic surgical repair for enterocele
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Typical site of service: Hospital operating room or outpatient surgical center where abdominal gynecologic surgery is performed.
Clinical & Coding Specifications
Clinical Context
A typical patient is a postmenopausal woman presenting with pelvic pressure, a visible or palpable vaginal bulge, and intermittent small-bowel obstruction symptoms such as cramping, nausea, or constipation. Physical exam and pelvic imaging confirm an enterocele (herniation of small bowel into the vaginal canal) with descent of the vaginal cuff or posterior vaginal wall. Prior pelvic surgeries or vaginal wall defects may be present. The surgeon elects an abdominal approach using a Halban or Moschowitz repair to reduce the small bowel, reapproximate and reinforce the vaginal wall, and restore pelvic support.
Preoperative workflow includes history and physical, imaging (pelvic ultrasound or CT as indicated), bowel preparation per institutional protocol if needed, informed consent discussing abdominal approach risks, and pre-anesthesia evaluation. Intraoperative steps commonly include exploratory laparotomy or laparoscopy converted to laparotomy as indicated, reduction of the enterocele contents, placement of sutures or reinforcement of the vaginal wall defect (Halban or Moschowitz technique), hemostasis, and abdominal closure. Postoperative care includes monitoring for return of bowel function, pain control, wound care, and follow-up pelvic examination to assess repair integrity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or initial service | Primary procedure performed by the reporting surgeon when no other global modifiers apply |