Summary & Overview
CPT 57423: Laparoscopic Paravaginal Defect Repair, ± Cystocele
CPT code 57423 represents a laparoscopic repair of a paravaginal defect, often performed to correct pelvic organ support adjacent to the vaginal wall and commonly combined with cystocele repair when indicated. Nationally, this code reflects utilization of minimally invasive pelvic reconstructive surgery techniques that impact surgical coding, facility resource planning, and payer coverage policies for gynecologic procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for CPT code 57423, including typical sites of service (hospital outpatient departments and ambulatory surgery centers), common clinical indications, and how the code fits within pelvic reconstructive service lines.
The publication summarizes available benchmarks and reimbursement considerations, highlights policy and coding guidance relevant to laparoscopic paravaginal repair, and outlines operational implications for providers and facilities. Where specific data elements were not provided in the input, the text notes that those items are not available. The goal is to give clinicians, coding professionals, and payers a concise reference to the code’s clinical meaning, billing context, and the topics to investigate further for local coverage and payment practices.
Billing Code Overview
CPT code 57423 describes a laparoscopic repair of a paravaginal defect, which may include a concurrent cystocele repair when performed as part of the same operative session. This procedure addresses pelvic support defects adjacent to the vaginal wall using minimally invasive, laparoscopic techniques.
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Service type: Gynecologic surgical procedure, pelvic reconstructive surgery
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Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–70-year-old parous woman who presents with symptomatic pelvic organ prolapse characterized by a lateral vaginal wall defect (paravaginal defect) often accompanied by anterior compartment descent (cystocele). She reports pelvic pressure, a vaginal bulge, urinary frequency, or recurrent urinary tract symptoms worsened by Valsalva. Conservative management (pessary, pelvic floor physical therapy) has failed or is declined; the patient elects surgical repair.
The clinical workflow includes preoperative evaluation with history, pelvic examination including POP-Q assessment, urinalysis, and pelvic imaging as indicated. The patient undergoes general anesthesia and laparoscopic paravaginal repair (57423) via transabdominal laparoscopy with identification and reattachment of lateral vaginal sulcus to the pelvic sidewall at the arcus tendineus. A concurrent laparoscopic cystocele repair (anterior colporrhaphy or paravaginal fixation) may be performed during the same operative session. Intraoperative documentation should include approach (laparoscopic), laterality if applicable, concurrent procedures, estimated blood loss, complications, and disposition. Postoperative care includes routine recovery, pain control, instructions on activity restriction, and follow-up for wound and pelvic support assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |