Summary & Overview
CPT 57425: Laparoscopic Suspension of Vaginal Apex for Vault Prolapse
CPT code 57425 represents a laparoscopic suspension of the vaginal apex (vaginal vault) to a strong supporting structure using sutures or mesh to correct vaginal vault prolapse. The code captures a minimally invasive pelvic reconstructive procedure commonly performed after hysterectomy or when vault descent impairs pelvic floor function. Nationally, this code is significant because it reflects the use of laparoscopic techniques in pelvic organ prolapse management and factors into surgical quality, utilization, and reimbursement discussions across payers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent, typical sites of service, and common billing considerations tied to this procedure. The publication provides benchmarks for utilization and allowed amounts where available, summarizes relevant policy and coverage themes affecting access to laparoscopic prolapse repair, and outlines coding and clinical context that influence payer adjudication. The material is intended for clinicians, billing professionals, and policy analysts seeking a clear, national-level understanding of how CPT code 57425 is used and reimbursed in contemporary practice.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific rate details.
Billing Code Overview
CPT code 57425 describes a laparoscopic suspension of the vaginal apex (vaginal vault) to a strong supporting structure using sutures or mesh to treat vaginal vault prolapse. The procedure is performed via a minimally invasive, laparoscopic approach to restore pelvic support after hysterectomy or when the vaginal apex has descended.
Service type: Surgical — Minimally invasive pelvic reconstructive surgery
Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 62-year-old woman with symptomatic post-hysterectomy pelvic organ prolapse presents with vaginal pressure, difficulty with standing and exertion, and a visible vaginal vault prolapse on exam. Conservative measures (pessary and pelvic floor therapy) failed or were declined. After preoperative evaluation and informed consent, the patient is scheduled for a laparoscopic sacrocolpopexy using sutures or mesh to suspend the vaginal vault to the sacral promontory under general anesthesia. Typical workflow: preoperative assessment in clinic (history, pelvic exam, urinalysis), pre-op anesthesia evaluation, laparoscopic case performed in an operating room with appropriate implants and instrumentation, intraoperative cystoscopy if indicated, postoperative recovery in PACU with same-day discharge or overnight observation, and follow-up visits at 2 weeks and 6 weeks for wound and symptom assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds typical for a laparoscopic sacrocolpopexy due to extensive adhesiolysis or complex anatomy. |
23 | Unusual anesthesia | Use when general anesthesia is contraindicated and an unusual anesthetic technique is recorded (limited applicability for laparoscopic procedures). |