Summary & Overview
CPT 57540: Excision of Cervical Stump, Abdominal Approach
CPT code 57540 represents the abdominal excision (amputation) of the cervical stump left after a prior subtotal hysterectomy. Nationally, this gynecologic surgical code is used when definitive removal of the residual cervix is required and may affect operative planning, site-of-service decisions, and payer coverage determinations. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical scope of the procedure, typical sites of service, common modifiers associated with surgical services, and how major payers commonly handle coverage and coding practices for gynecologic surgical procedures. The summary also provides context for benchmarking utilization and reimbursement patterns and highlights considerations for claims documentation and coding specificity. Data not available in the input for detailed payer-specific rates, ICD-10 diagnosis pairings, associated taxonomies, and related codes.
Billing Code Overview
CPT code 57540 describes surgical excision of the cervical stump remaining after a prior subtotal hysterectomy. The procedure involves amputation of the cervical remnant through an abdominal approach and is performed when removal of the residual cervix is clinically indicated after the initial procedure left the cervix intact.
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Service type: Surgical procedure — gynecologic abdominal surgery
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Typical site of service: Inpatient or outpatient hospital surgical setting or ambulatory surgery center, depending on clinical factors and payer/site capabilities.
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman with a prior subtotal (supracervical) hysterectomy presents with chronic pelvic pain and abnormal vaginal bleeding. Imaging demonstrates cervical stump pathology consistent with cervical dysplasia and fibrotic scarring at the cervical remnant. After counseling and preoperative evaluation, the gynecologic surgeon schedules an abdominal cervical stump excision (trachelectomy of the remaining cervix) via an open abdominal approach. The clinical workflow includes preoperative history and physical, informed consent, anesthesia evaluation, preoperative antibiotics, abdominal incision and dissection to the cervical stump, amputation of the cervical remnant with hemostasis, closure, postoperative recovery, and pathology submission of the specimen. Typical perioperative documentation includes indication, prior subtotal hysterectomy in the history, operative report describing amputation through an abdominal approach, estimated blood loss, specimen disposition, and postoperative instructions for wound care and activity restriction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work required is substantially greater than typical for the procedure (extensive adhesiolysis or unexpected complexity). |
23 |