Summary & Overview
CPT 57330: Vesicovaginal Fistula Repair, Combined Abdominal and Vaginal Approach
CPT code 57330 denotes surgical repair of a vesicovaginal fistula by combined abdominal (transvesical) incision and vaginal repair. This operative code captures a complex reconstructive pelvic procedure performed by gynecologic or urologic surgeons to close an abnormal connection between the bladder and vagina. Nationally, coding and coverage for fistula repairs affect hospital and ambulatory surgery workflows, perioperative resource use, and quality reporting for pelvic reconstructive services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and coding-focused overview of the procedure, typical sites of service, and the operational context in which 57330 is used. The publication also summarizes benchmark considerations for procedure utilization, common billing modifiers and payer authorization patterns (where available), and clinical context relevant to claims processing and care coordination.
The content is intended to inform coding professionals, revenue cycle analysts, and clinical leaders about the clinical nature of the service, payer coverage landscape, and the topics to review further for claims compliance and performance monitoring. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 57330 describes a surgical repair of a vesicovaginal fistula using a combined abdominal (transvesical) and vaginal approach. The procedure involves an abdominal incision with an incision into the bladder to repair the fistula from above, combined with a vaginal component to complete the repair.
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Service type: Surgical repair (combined abdominal and vaginal fistula repair)
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Typical site of service: Hospital operating room or ambulatory surgical center, performed by a surgeon with urology or gynecologic surgery expertise
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 35–60-year-old woman presenting with continuous urinary leakage and recurrent urinary tract infections months after pelvic surgery or obstetric trauma. Evaluation includes history, pelvic and vaginal examination demonstrating urine pooling, dye testing (eg, methylene blue), cystoscopy to localize bladder fistula, and imaging as needed. When conservative measures fail or defect is persistent, the patient is scheduled for operative repair. The surgeon performs a combined transabdominal and transvaginal approach: an abdominal incision (often lower midline or Pfannenstiel) to access and incise the bladder for mobilization and layered bladder closure, and a vaginal approach to repair the vaginal defect and interpose tissue (eg, omental or Martius flap) as indicated. Typical perioperative workflow includes preoperative bowel and urinary preparation, general anesthesia, intraoperative cystoscopy, ureteral stent placement if indicated, layered bladder and vaginal closure, placement of drains and urinary catheter, and postoperative bladder drainage with catheterization for several days to weeks and follow-up cystogram prior to catheter removal. Usual sites of service are hospital inpatient or hospital outpatient surgical settings depending on acuity and anticipated postoperative stay.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special reporting modifier applies |