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CPT 57335: Vaginoplasty Using Existing Tissue

CPT code 57335 covers surgical creation of a vaginal canal using the patient’s existing tissue. The procedure is used in contexts including gender-affirming surgery and reconstruction for intersex patients whose anatomy does not conform to binary sex classifications. Nationally, this code is relevant to surgical practice patterns, payer coverage policies for gender-affirming and reconstructive care, and facility planning for operative services.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which major payers are commonly involved in coverage determinations. The publication summarizes reimbursement benchmarks where available, highlights policy developments affecting authorization and coverage, and outlines coding considerations for documentation and billing workflows.

This material is intended for revenue cycle managers, surgical program administrators, and policy analysts seeking a national overview of how CPT code 57335 is used in clinical and payer contexts. Data not available in the input will be identified as such in relevant sections.

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Billing Code Overview

CPT code 57335 describes a surgical procedure in which the provider uses existing tissue to create a vaginal canal for the patient. This procedure is typically performed as part of gender-affirming surgery or reconstruction for individuals with intersex variations whose reproductive or sexual anatomy does not align with a binary male or female classification.

Service type: Genital reconstruction / vaginoplasty using existing tissue
Typical site of service: Inpatient or outpatient surgical setting (operating room)

Data not available in the input.

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CPT 57335: Vaginoplasty Using Existing Tissue

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Billing Code Overview

Service type: Genital reconstruction / vaginoplasty using existing tissue
Typical site of service: Inpatient or outpatient surgical setting (operating room)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adolescent or adult presenting for creation of a vaginal canal using existing tissue (vaginoplasty using local tissue). The indication may be congenital genital difference (e.g., intersex anatomy with absent or underdeveloped vaginal canal), post-traumatic or post-infectious vaginal stenosis, or gender-affirming genital surgery where local tissue is preferred. Preoperative evaluation includes medical history, psychosocial assessment, informed consent, hormone therapy review if applicable, pelvic exam, imaging as indicated, and anesthetic clearance.

The clinical workflow: outpatient consultation and counseling, preoperative planning with surgical consent and documentation of diagnosis codes, same-day admission to an ambulatory surgical center or hospital operating room (typical site of service: OR at hospital or ambulatory surgical center). General anesthesia is commonly used. The surgeon creates a neovaginal canal by mobilizing perineal or vulvar tissue (skin flaps, mucosal advancement, or inversion techniques) and establishes a patent cavity often with a stent or packing. Postoperative care includes pain control, antibiotics as indicated, wound care instructions, dilation protocol to maintain patency, and scheduled follow-up visits for wound checks and functional assessment. Documentation should include procedure details, tissue source, closure technique, drains or stents placed, estimated blood loss, complications, and postoperative instructions.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to perform `57335` is substantially greater than usual (document increased work).
`24`	Unrelated evaluation and management service during postoperative period	Use when a separate E/M unrelated to `57335` is provided during global period.
`25`	Significant, separately identifiable E/M service on same day	Use when a distinct E/M is performed on same day as `57335` and is above usual preoperative work.
`50`	Bilateral procedure	Use if anatomic or coding guidance requires bilateral reporting and modifier applies (rare for `57335`).
`51`	Multiple procedures	Use when `57335` is billed with other distinct procedures in same session; indicate multiple procedure reduction applicability.
`52`	Reduced services	Use when procedure is partially reduced or not completed as planned and documentation supports reduction.
`53`	Discontinued procedure	Use when `57335` is started but discontinued due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons on `57335`.
`66`	Surgical team technique	Use when a surgical team performs `57335` per facility/team protocol.
`76`	Repeat procedure by same physician	Use when `57335` is repeated subsequent to an earlier attempt by same physician (modifier `76` may be represented by `U1`/regional codes in some payors).
`78`	Return to OR for related procedure during global period	Use if patient returns to OR for a complication related to `57335` during the global period.
`79`	Unrelated procedure during postoperative period	Use when an unrelated procedure is performed during the global period (note: `79` not in provided list; omitted).

Taxonomy Code	Specialty	Notes
2080S0001X	Obstetrics & Gynecology	Gynecologic surgeons commonly perform vaginal reconstruction procedures.
2086S0122X	Plastic Surgery	Reconstructive plastic surgeons perform complex tissue rearrangement and flap techniques.
2084P0800X	Urology	Genitourinary surgeons may be involved when urologic structures require management.
208D00000X	General Surgery	General surgeons with pelvic reconstructive experience may perform this procedure.
208U00000X	Colon & Rectal Surgery	Mayo perform perineal/ pelvic floor-related reconstructions when bowel or perineal structures are involved.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N89.8`	Other specified noninflammatory disorders of vagina	May describe congenital or acquired noninflammatory vaginal anomalies leading to reconstruction.
`Q52.5`	Hypospadias, unspecified	Included for completeness when intersex/ambiguous genitalia require reconstruction; may coexist with vaginal agenesis or atypical anatomy.
`Q52.2`	Vaginal agenesis	Primary congenital indication for creation of a vaginal canal using existing tissue.
`Z87.890`	Personal history of sex reassignment	Relevant in gender-affirming context when reconstructive procedures are performed.
`N99.89`	Other postoperative complications and disorders of genitourinary system	Used for post-op complication coding when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`54120`	Reconstruction of vagina, with or without vaginoplasty; using local tissue	Similar reconstructive technique; may be an alternative coding option depending on technique and documentation.
`55970`	Repair of male-to-female sex reassignment, vaginoplasty (including clitoroplasty and creation of labia)	Often part of broader gender-affirming surgical series when orchiectomy or additional genital procedures are performed in same episode of care.
`57291`	Application of pessary	May be used postoperatively in nonoperative management of vaginal support or to maintain neovaginal patency in select cases.
`57425`	Colposcopy of the cervix with biopsy	May be performed preoperatively if evaluation of Müllerian structures or cervical tissue is required.
`17840`	Excision or destruction of benign lesion on external genitalia	Perineal or vulvar lesion excision may be performed concurrently or in staged care related to tissue mobilization.

CPT 57200: Repair of Nonobstetric Vaginal Wall Laceration

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 Surgery

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

CPT 57230: Repair of Urethrocele (Urethral Prolapse into Vagina)

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

CPT 57240: Anterior Vaginal Wall Repair (Cystocele)

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

CPT 57250: Posterior Vaginal Wall Repair (Rectocele) with Perineal Repair

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

CPT 57260: Vaginal Repair of Bladder and Rectum Prolapse

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

CPT 57265: Vaginal Repair of Pelvic Organ Prolapse with Enterocele

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

CPT 57267: Vaginal Prosthetic Graft for Anterior/Posterior Vaginal Wall

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

CPT 57268: Vaginal Repair for Small Bowel Prolapse

Showing 1–10 of 31

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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to perform `57335` is substantially greater than usual (document increased work).
`24`	Unrelated evaluation and management service during postoperative period	Use when a separate E/M unrelated to `57335` is provided during global period.
`25`	Significant, separately identifiable E/M service on same day	Use when a distinct E/M is performed on same day as `57335` and is above usual preoperative work.
`50`	Bilateral procedure	Use if anatomic or coding guidance requires bilateral reporting and modifier applies (rare for `57335`).
`51`	Multiple procedures	Use when `57335` is billed with other distinct procedures in same session; indicate multiple procedure reduction applicability.
`52`	Reduced services	Use when procedure is partially reduced or not completed as planned and documentation supports reduction.
`53`	Discontinued procedure	Use when `57335` is started but discontinued due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons on `57335`.
`66`	Surgical team technique	Use when a surgical team performs `57335` per facility/team protocol.
`76`	Repeat procedure by same physician	Use when `57335` is repeated subsequent to an earlier attempt by same physician (modifier `76` may be represented by `U1`/regional codes in some payors).
`78`	Return to OR for related procedure during global period	Use if patient returns to OR for a complication related to `57335` during the global period.
`79`	Unrelated procedure during postoperative period	Use when an unrelated procedure is performed during the global period (note: `79` not in provided list; omitted).

Taxonomy Code	Specialty	Notes
2080S0001X	Obstetrics & Gynecology	Gynecologic surgeons commonly perform vaginal reconstruction procedures.
2086S0122X	Plastic Surgery	Reconstructive plastic surgeons perform complex tissue rearrangement and flap techniques.
2084P0800X	Urology	Genitourinary surgeons may be involved when urologic structures require management.
208D00000X	General Surgery	General surgeons with pelvic reconstructive experience may perform this procedure.
208U00000X	Colon & Rectal Surgery	Mayo perform perineal/ pelvic floor-related reconstructions when bowel or perineal structures are involved.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N89.8`	Other specified noninflammatory disorders of vagina	May describe congenital or acquired noninflammatory vaginal anomalies leading to reconstruction.
`Q52.5`	Hypospadias, unspecified	Included for completeness when intersex/ambiguous genitalia require reconstruction; may coexist with vaginal agenesis or atypical anatomy.
`Q52.2`	Vaginal agenesis	Primary congenital indication for creation of a vaginal canal using existing tissue.
`Z87.890`	Personal history of sex reassignment	Relevant in gender-affirming context when reconstructive procedures are performed.
`N99.89`	Other postoperative complications and disorders of genitourinary system	Used for post-op complication coding when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`54120`	Reconstruction of vagina, with or without vaginoplasty; using local tissue	Similar reconstructive technique; may be an alternative coding option depending on technique and documentation.
`55970`	Repair of male-to-female sex reassignment, vaginoplasty (including clitoroplasty and creation of labia)	Often part of broader gender-affirming surgical series when orchiectomy or additional genital procedures are performed in same episode of care.
`57291`	Application of pessary	May be used postoperatively in nonoperative management of vaginal support or to maintain neovaginal patency in select cases.
`57425`	Colposcopy of the cervix with biopsy	May be performed preoperatively if evaluation of Müllerian structures or cervical tissue is required.
`17840`	Excision or destruction of benign lesion on external genitalia	Perineal or vulvar lesion excision may be performed concurrently or in staged care related to tissue mobilization.

CPT 57200: Repair of Nonobstetric Vaginal Wall Laceration

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 Surgery

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

CPT 57230: Repair of Urethrocele (Urethral Prolapse into Vagina)

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

CPT 57240: Anterior Vaginal Wall Repair (Cystocele)

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

CPT 57250: Posterior Vaginal Wall Repair (Rectocele) with Perineal Repair

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

CPT 57260: Vaginal Repair of Bladder and Rectum Prolapse

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

CPT 57265: Vaginal Repair of Pelvic Organ Prolapse with Enterocele

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

CPT 57267: Vaginal Prosthetic Graft for Anterior/Posterior Vaginal Wall

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

CPT 57268: Vaginal Repair for Small Bowel Prolapse

Showing 1–10 of 31

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.

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CPT 57335: Vaginoplasty Using Existing Tissue

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Billing Code Overview

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CPT 57335: Vaginoplasty Using Existing Tissue

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References