CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Medicare pays $496 on average nationally for this procedure.

CPT code 57291 describes construction of an artificial vagina without use of a graft to treat congenital absence of a vagina (vaginal agenesis); this is a surgical pelvic procedure (vaginoplasty without graft) typically performed in an operating room or ambulatory surgical center and classified as reconstructive gynecologic surgery.

For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.

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CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Medicare pays $496 on average nationally for this procedure.

For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.

Customize your policy alerts

Sign up for cpt 57291 policy alerts

Get alerted when payer policies referencing 57291 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adolescent or young adult assigned female at birth presenting with primary amenorrhea, cyclic pelvic pain, or difficulty with intercourse, and is diagnosed with vaginal agenesis or Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. After multidisciplinary evaluation including gynecology, reproductive endocrinology, and counseling, the patient elects surgical creation of a neovagina when non-surgical dilation has failed or is not feasible. Preoperative workup includes pelvic imaging (MRI or ultrasound) to define anatomy, assessment for renal or skeletal anomalies, laboratory studies, and informed consent addressing fertility and sexual function.

The procedure 57291 is performed in an operating room under general anesthesia by a gynecologic surgeon or pediatric/adolescent gynecologic specialist. Intraoperative steps typically include dissection to create a vaginal canal between the rectum and bladder, creation of a mucosal-lined neovaginal cavity without use of grafts, hemostasis, and placement of stent or dilator. Postoperative care involves inpatient or ambulatory recovery, pain control, prophylactic antibiotics if indicated, instructions for dilation schedule, wound and stent care, and outpatient follow-up with the surgical team and pelvic rehabilitation as needed.

Common clinical documentation elements include indications (congenital absence of vagina), preoperative imaging and exam findings, informed consent, operative report describing technique and absence of graft use, estimated blood loss, any intraoperative complications, and postoperative dilation plan.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57425`	Colposcopy of the cervix including upper/adjacent vagina, with biopsy(s) when performed	May be performed preoperatively for evaluation of vaginal mucosa or concurrent biopsy if abnormal tissue is present.
`57288`	Colposuspension for urinary incontinence (sling procedures are `57288` family)	May be performed in the same surgical setting if concomitant pelvic floor reconstruction is required, though not routine with `57291`.
`57454`	Colposcopy of the cervix including upper/adjacent vagina with loop electrode biopsy(s)	May be used for diagnostic evaluation prior to definitive reconstructive surgery if mucosal abnormalities are suspected.
`57460`	Colposcopy of vulva; simple	Performed for evaluation of vulvar pathology before or after neovaginal construction.
`54050`	Circumcision, surgical; neonatal	Data not available in the input.

Note: If any listed CPT descriptions or relationships are inconsistent with a payer or facility policy, payer-specific billing guidelines should be consulted for bundling rules and global periods.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology Physician	An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
246ZE0500X	EEG Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
2084P0802X	Addiction Psychiatry Physician	Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-re…
1835X0200X	Oncology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharma…
207NP0225X	Pediatric Dermatology Physician	A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emph…
207ZH0000X	Hematology (Pathology) Physician	A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the know…
207XS0106X	Orthopaedic Hand Surgery Physician	An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of t…

Related Payer Policy Updates

Specialty: Obstetrics/Gynecology1 / 3

10 rows

Policy	Payer	Effective Date
Prolonged Services for Labor Management	Premera Bluecross	2027-01-01
Prolonged Services for Labor Management	Premera Bluecross	2027-01-01
Cervical Cancer Screening	Oscar Health	2026-10-01
Prenatal Testing for Fetal Aneuploidy	Oscar Health	2026-10-01
Diagnosis of Vaginitis	Oscar Health	2026-10-01
Prenatal Screening (Nongenetic)	Oscar Health	2026-10-01
View PDF of Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes, Effective 10/1/2026 in Medical	Blue Cross Blue Shield - Rhode Island	2026-10-01
Maternal Serum Testing for Prediction of Adverse Obstetric Outcomes	Bluecross Idaho	2026-09-01
Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound)	Cigna	2026-08-15
Abortion — Treatment of Complications and Coverage Criteria	Cigna	2026-08-08

CPT 57200: Vaginal Wall Laceration Repair, Nonobstetric

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

CPT 57210: Repair of Vaginal Wall or Perineal Laceration (Nonobstetric)

CPT-57220-URETHRAL-REDUCTION-AND-SUPPORT-SURGERY

CPT 57220: Urethral Reduction and Support Procedure

CPT-57230-URETHROCELE-REPAIR-URETHRAL-PROLAPSE-REPAIR

CPT 57230: Urethrocele Repair (Vaginal Urethral Repair)

CPT-57240-ANTERIOR-VAGINAL-WALL-REPAIR-CYSTOCELE

CPT 57240: Vaginal Repair of Cystocele

CPT-57250-RECTOCELE-REPAIR-POSTERIOR-VAGINAL-WALL-REPAIR

CPT 57250: Repair of Rectocele with Perineorrhaphy

CPT-57260-VAGINAL-REPAIR-BLADDER-RECTUM-PROLAPSE

CPT 57260: Vaginal Repair for Bladder and Rectal Prolapse

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

CPT 57265: Vaginal Repair of Enterocele and Vaginal Wall Defects

CPT-57267-VAGINAL-PROSTHETIC-GRAFT-ANTERIOR-POSTERIOR-VAGINAL-WALL

CPT 57267: Vaginal Prosthetic Graft Placement, Anterior/Posterior

CPT-57268-VAGINAL-REPAIR-SMALL-BOWEL-PROLAPSE

CPT 57268: Vaginal Repair of Enterocele (Small Bowel Prolapse)

Showing 1–10 of 31

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57425`	Colposcopy of the cervix including upper/adjacent vagina, with biopsy(s) when performed	May be performed preoperatively for evaluation of vaginal mucosa or concurrent biopsy if abnormal tissue is present.
`57288`	Colposuspension for urinary incontinence (sling procedures are `57288` family)	May be performed in the same surgical setting if concomitant pelvic floor reconstruction is required, though not routine with `57291`.
`57454`	Colposcopy of the cervix including upper/adjacent vagina with loop electrode biopsy(s)	May be used for diagnostic evaluation prior to definitive reconstructive surgery if mucosal abnormalities are suspected.
`57460`	Colposcopy of vulva; simple	Performed for evaluation of vulvar pathology before or after neovaginal construction.
`54050`	Circumcision, surgical; neonatal	Data not available in the input.

Note: If any listed CPT descriptions or relationships are inconsistent with a payer or facility policy, payer-specific billing guidelines should be consulted for bundling rules and global periods.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology Physician	An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
246ZE0500X	EEG Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
2084P0802X	Addiction Psychiatry Physician	Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-re…
1835X0200X	Oncology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharma…
207NP0225X	Pediatric Dermatology Physician	A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emph…
207ZH0000X	Hematology (Pathology) Physician	A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the know…
207XS0106X	Orthopaedic Hand Surgery Physician	An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of t…

Related Payer Policy Updates

Specialty: Obstetrics/Gynecology1 / 3

10 rows

Policy	Payer	Effective Date
Prolonged Services for Labor Management	Premera Bluecross	2027-01-01
Prolonged Services for Labor Management	Premera Bluecross	2027-01-01
Cervical Cancer Screening	Oscar Health	2026-10-01
Prenatal Testing for Fetal Aneuploidy	Oscar Health	2026-10-01
Diagnosis of Vaginitis	Oscar Health	2026-10-01
Prenatal Screening (Nongenetic)	Oscar Health	2026-10-01
View PDF of Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes, Effective 10/1/2026 in Medical	Blue Cross Blue Shield - Rhode Island	2026-10-01
Maternal Serum Testing for Prediction of Adverse Obstetric Outcomes	Bluecross Idaho	2026-09-01
Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound)	Cigna	2026-08-15
Abortion — Treatment of Complications and Coverage Criteria	Cigna	2026-08-08

CPT 57200: Vaginal Wall Laceration Repair, Nonobstetric

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

CPT 57210: Repair of Vaginal Wall or Perineal Laceration (Nonobstetric)

CPT-57220-URETHRAL-REDUCTION-AND-SUPPORT-SURGERY

CPT 57220: Urethral Reduction and Support Procedure

CPT-57230-URETHROCELE-REPAIR-URETHRAL-PROLAPSE-REPAIR

CPT 57230: Urethrocele Repair (Vaginal Urethral Repair)

CPT-57240-ANTERIOR-VAGINAL-WALL-REPAIR-CYSTOCELE

CPT 57240: Vaginal Repair of Cystocele

CPT-57250-RECTOCELE-REPAIR-POSTERIOR-VAGINAL-WALL-REPAIR

CPT 57250: Repair of Rectocele with Perineorrhaphy

CPT-57260-VAGINAL-REPAIR-BLADDER-RECTUM-PROLAPSE

CPT 57260: Vaginal Repair for Bladder and Rectal Prolapse

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

CPT 57265: Vaginal Repair of Enterocele and Vaginal Wall Defects

CPT-57267-VAGINAL-PROSTHETIC-GRAFT-ANTERIOR-POSTERIOR-VAGINAL-WALL

CPT 57267: Vaginal Prosthetic Graft Placement, Anterior/Posterior

CPT-57268-VAGINAL-REPAIR-SMALL-BOWEL-PROLAPSE

CPT 57268: Vaginal Repair of Enterocele (Small Bowel Prolapse)

Showing 1–10 of 31

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Sign up for cpt 57291 policy alerts

OpenPayer

CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Sign up for cpt 57291 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Sign up for cpt 57291 policy alerts

CPT 57291: Vaginoplasty, No Graft, for Vaginal Agenesis

Sign up for cpt 57291 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical indication and setting are described for CPT 57291?

What clinical documentation should be included when billing CPT 57291?

Which modifiers are commonly used with CPT 57291 and when should they be applied?

Which specialties or provider taxonomy codes commonly perform or support this procedure?

Are there related CPT codes or bundling considerations to be aware of with 57291?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical indication and setting are described for CPT 57291?

What clinical documentation should be included when billing CPT 57291?

Which modifiers are commonly used with CPT 57291 and when should they be applied?

Which specialties or provider taxonomy codes commonly perform or support this procedure?

Are there related CPT codes or bundling considerations to be aware of with 57291?

References