Summary & Overview

CPT 57426: Laparoscopic Revision or Removal of Vaginal Graft

CPT code 57426 designates laparoscopic revision or removal of a previously placed vaginal graft, a gynecologic surgical procedure used when graft material becomes exposed, eroded, or inflamed. Nationally, this code captures interventions to address complications of prior pelvic reconstructive surgeries and is relevant for surgical quality measurement, utilization monitoring, and reimbursement classification.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context, common settings for service delivery, and the administrative elements payers typically consider when adjudicating claims for graft revision or removal.

Readers will find benchmarks for utilization and allowed services, concise clinical context on indications for graft removal or revision, and summaries of payer policy themes and prior authorization considerations where available. The content also highlights coding and billing nuances tied to laparoscopic approach versus open procedures and identifies gaps where data is not available for this input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare57426CPTgynecologic surgerylaparoscopyvaginal graft revisionsurgical removalpelvic reconstructive surgeryoperative procedure

Billing Code Overview

CPT code 57426 describes the revision or removal of a previously placed vaginal graft performed using a laparoscope. The service addresses situations in which a prior vaginal graft requires partial or complete removal due to complications such as erosion, exposure, or inflammation.

Service type: Surgical procedure for graft revision or removal
Typical site of service: Operative suite or ambulatory surgery center where laparoscopic gynecologic surgery is provided

Clinical & Coding Specifications

Clinical Context

A 62-year-old female with a history of transvaginal mesh placement for pelvic organ prolapse presents with persistent vaginal pain, recurrent discharge, and partial exposure of the synthetic graft on exam. Conservative measures including local estrogen, topical antibiotics, and office-based trimming were attempted without durable improvement. Imaging and exam localize erosion and surrounding inflammation without deep organ involvement. The patient is scheduled for a laparoscopic removal or revision of the previously placed vaginal graft (CPT 57426) under general anesthesia. Preoperative workflow includes surgical consent, pre-op labs and anesthesia assessment, cystoscopy intraoperatively if bladder involvement is suspected, and postoperative follow-up for wound healing, pain control, and pelvic floor rehabilitation. The typical site of service is an ambulatory surgery center or hospital outpatient department where laparoscopic gynecologic procedures are performed.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when intraoperative complexity (extensive adhesiolysis or difficult graft removal) requires substantially greater resources than typical for `57426`.

Taxonomy Code	Specialty	Notes
207V00000X	Obstetrics & Gynecology	Gynecologic surgeons commonly perform laparoscopic graft revisions or removals.
207VR0400X	Female Pelvic Medicine & Reconstructive Surgery	Subspecialists managing complex pelvic organ prolapse and mesh complications.
207LH0000X	Minimally Invasive Gynecologic Surgery	Surgeons focused on laparoscopic management of pelvic reconstructive issues.
2080P0800X	Urogynecology (if separate taxonomy used)	Clinicians addressing mesh erosion with potential urinary tract involvement.
363L00000X	General Surgery	May be involved when combined abdominal procedures or complex adhesiolysis is required.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57426`	Laparoscopy, surgical; revision or removal of previous transvaginal graft (e.g., for prolapse)	Primary procedure for laparoscopic revision or removal of an eroded, exposed, or inflamed vaginal graft.
`57425`	Laparoscopy, surgical; removal of vaginal graft without revision (if listed separately)	May be used when removal only is performed without concomitant revision steps — select per operative documentation.
`57288`	Colpopexy, abdominal approach (suspension of vaginal apex)	May be performed at the same setting if pelvic support reconstruction is required after graft removal.
`57420`	Laparoscopy, surgical; removal of vaginal contraceptive or other foreign body	Related when removal of foreign material is the primary issue; selection depends on specific tissue and approach.
`52000`	Cystoscopy, diagnostic (separate procedure)	Performed intraoperatively or pre/postoperatively to evaluate bladder integrity if erosion or fistula is suspected.
`57430`	Laparoscopy, surgical; repair of vaginal cuff (if applicable)	Performed when graft removal necessitates repair of vaginal wall defects or cuff revision.

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