Summary & Overview
CPT 57285: Paravaginal Defect Repair, Vaginal Approach
Headline: CPT code 57285: Vaginal repair of paravaginal defect, often with cystocele repair
Lead: CPT code 57285 identifies a vaginal surgical procedure to repair a paravaginal defect by dissecting tissues between the vagina, bladder, and urethra; a cystocele repair may be performed concurrently. The code is relevant across surgical specialties that manage pelvic organ prolapse and impacts facility and professional billing for urogynecologic procedures nationwide.
What the code represents and why it matters: CPT code 57285 captures a targeted vaginal reconstructive surgery addressing lateral support defects that contribute to cystocele and related pelvic floor dysfunction. Accurate coding affects procedural reporting, bundled payment considerations, and clinical quality measurement for pelvic reconstructive services.
Key payers covered: Analysis commonly includes major national payers such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: Readers will gain a concise overview of the clinical intent of CPT code 57285, typical care settings where the procedure is performed, and the billing context relevant to national payers. The publication covers benchmark considerations, coding guidance context, and clinical background to support appropriate use of the code.
Note: Data not available in the input for detailed payer-specific reimbursement rates, associated taxonomies, and ICD-10 diagnosis pairings.
Billing Code Overview
CPT code 57285 describes a surgical repair of a paravaginal defect performed through a vaginal approach. The procedure involves dissection of tissues between the vagina, the bladder, and the urethra to correct lateral defects of the vaginal support. The description notes that a cystocele repair may be performed as part of the same procedure.
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Service type: Vaginal reconstructive surgery for pelvic organ prolapse repair
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Typical site of service: Inpatient or outpatient surgical setting with a vaginal operative approach
Clinical & Coding Specifications
Clinical Context
A typical patient is a 56-year-old parous woman presenting with symptomatic anterior vaginal wall bulge and urinary frequency consistent with a cystocele and paravaginal defect after prior vaginal deliveries. She reports pelvic pressure, difficulty with bladder emptying, and worsening urinary stress incontinence. Conservative measures including pelvic floor physical therapy and pessary failed to relieve symptoms. Preoperative evaluation includes pelvic exam confirming lateral detachment of the pubocervical fascia, urogynecologic assessment, urinalysis, and pelvic ultrasound or urodynamics as indicated. The provider schedules a vaginal approach paravaginal repair (57285) under regional or general anesthesia. Intraoperatively, the surgeon dissects the tissues between the vagina, bladder, and urethra to reattach the lateral pubocervical fascia to the pelvic sidewall; a cystocele repair may be performed concurrently. Typical workflow includes preoperative consent and documentation of symptoms and prior treatments, anesthesia consent, operative note documenting indication and steps of dissection and fixation, estimated blood loss, and postoperative instructions for activity restriction and voiding trial. Common sites of service are outpatient surgical centers or hospital operating rooms.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds typical for and documentation supports additional resources. |