Summary & Overview
CPT 57282: Vaginal Colpopexy (Extraperitoneal) for Apical Suspension
CPT code 57282 represents a vaginal colpopexy using an extraperitoneal technique to suspend the vaginal apex to sacrospinous or iliococcygeus ligaments. This procedure restores apical support after pelvic organ prolapse and is a core surgical option for vault prolapse management. Nationally, accurate coding of apical suspension procedures matters for quality measurement, appropriate payment, and surgical outcomes tracking.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, typical payer coverage considerations, common modifiers seen in practice, and the types of benchmarks and policy items that influence coding and reimbursement for vaginal apical suspension procedures. The report highlights where additional documentation is commonly required and summarizes typical sites of service and the surgical nature of the intervention.
This publication provides a practical reference for clinical, billing, and administrative stakeholders seeking a national perspective on coding and classification for vaginal colpopexy via an extraperitoneal vaginal approach, including what to expect in payer interactions and areas where policy updates often affect coding practice.
Billing Code Overview
CPT code 57282 describes a colpopexy performed via a vaginal approach using an extraperitoneal technique. The surgeon suspends the vaginal apex (vault repair) by attaching it to the sacrospinous or iliococcygeus ligaments to restore pelvic support.
Service type: Surgical — Vaginal apical suspension (colpopexy) via extraperitoneal approach
Typical site of service: Hospital inpatient or outpatient surgical suite or ambulatory surgery center (vaginal operative setting)
Clinical & Coding Specifications
Clinical Context
A typical patient is a postmenopausal woman presenting with symptomatic vaginal vault prolapse following prior hysterectomy. She reports a sensation of pelvic pressure, vaginal bulge, and difficulty with pelvic function that affects activities of daily living. Pelvic examination confirms apical prolapse (vaginal vault descent) and conservative measures (pessary, pelvic floor physical therapy) have been unsuccessful or are declined.
The clinical workflow includes preoperative evaluation with history, physical exam, pelvic organ prolapse quantification (POP-Q), assessment of medical comorbidities, informed consent, and preoperative optimization. On the day of surgery the patient undergoes general or regional anesthesia in an ambulatory surgery center or hospital operating room. The surgeon performs a vaginal approach extraperitoneal colpopexy (vault repair), suspending the vaginal apex to the sacrospinous or iliococcygeus ligament with permanent or delayed-absorbable sutures. Intraoperative steps include exposure of the vaginal cuff, identification of the ligament, placement of suspension sutures, and restoration of vaginal length/tension; concomitant procedures (e.g., anterior or posterior colporrhaphy, perineorrhaphy, removal of mesh) may be performed during the same anesthetic. Postoperative care includes pain control, voiding assessment, activity restrictions, and follow-up for wound healing and prolapse recurrence monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |