Summary & Overview
CPT 57283: Vaginal Vault Suspension via Vaginal Approach
CPT code 57283 denotes a vaginal vault suspension performed via a vaginal approach, attaching the prolapsing vaginal vault to an internal peritoneal ligament. This procedure addresses symptomatic vault prolapse, a condition that can cause pelvic pressure, urinary dysfunction, and impaired quality of life. Nationally, procedures addressing pelvic organ prolapse are clinically significant due to their prevalence among post-hysterectomy and older female populations and because surgical approach impacts recovery, site of service, and reimbursement pathways. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical procedure, typical settings where it is furnished, and the payer landscape considered. The publication summarizes common modifiers and coding considerations when present, highlights related CPT procedures and diagnostic coding practices where available, and offers benchmark and policy context relevant to hospitals and ambulatory surgery centers. It also outlines typical documentation elements that support medical necessity for vault suspension procedures. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 57283 describes a surgical procedure in which the provider elevates (pulls up) a prolapsing vaginal vault through a vaginal approach and attaches it to a ligament within the peritoneal lining. This procedure is a form of vaginal vault suspension intended to correct vault prolapse following hysterectomy or other pelvic support compromise.
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Service type: Vaginal vault suspension via vaginal approach (surgical repair of vaginal vault prolapse)
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Typical site of service: Inpatient or outpatient surgical setting with a vaginal surgical suite; often performed in hospital operating rooms or ambulatory surgery centers depending on clinical complexity and patient factors.
Clinical & Coding Specifications
Clinical Context
A 68-year-old female presents with symptomatic apical vaginal vault prolapse several years after a total hysterectomy. She reports a bulge, pelvic pressure that worsens with Valsalva and activity, and occasional urinary urgency. Conservative measures including pelvic floor physical therapy and pessary use have been attempted without adequate relief. After evaluation by the gynecology or urogynecology team, the decision is made to perform a vaginal vault suspension to reattach and support the vaginal apex.
The procedure, coded as 57283, is performed in an operating room or ambulatory surgery center under regional or general anesthesia. The surgeon approaches transvaginally, identifies the prolapsed vaginal vault, mobilizes tissue as needed, and fixes the vaginal apex to an internal ligament within the peritoneal lining (commonly the uterosacral ligament attachment or sacrospinous-like fixation via peritoneal suspension techniques). Typical perioperative workflow includes preoperative counseling, informed consent, prophylactic antibiotics, intraoperative monitoring, placement of appropriate sutures or fixation device, hemostasis, and postoperative recovery with discharge instructions and follow-up for wound/healing and pelvic support assessment.
Typical site of service: hospital operating room or ambulatory surgery center. Service type: surgical — transvaginal apical vaginal vault suspension/attachment to pelvic ligaments.
Coding Specifications
| Modifier | Description | When to Use |
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