Summary & Overview
CPT 57545: Excision of Cervical Stump with Pelvic Floor Repair
CPT code 57545 denotes surgical excision of a residual cervical stump following a previous subtotal hysterectomy, performed via an abdominal amputation with concurrent pelvic floor repair. Nationally, this code captures a distinct gynecologic procedure used when the retained cervix requires removal for clinical indications such as persistent symptoms, pathology, or complications after subtotal hysterectomy. Accurate use of the code affects clinical documentation, hospital case mix, and surgical quality reporting.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides a concise reference for how 57545 is defined, expected sites of service, common surgical context, and the types of benchmarks and policy items stakeholders track. Readers will find an overview of reimbursement benchmarking considerations, payer coverage patterns where available, clinical context for when the procedure is performed, and implications for coding and billing workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 57545 describes the excision of the cervical stump remaining after a prior subtotal hysterectomy. The procedure involves amputation of the cervix through an abdominal approach and includes repair of the pelvic floor as part of the operative service.
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Service type: Surgical — gynecologic pelvic surgery
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Typical site of service: Hospital outpatient department or inpatient surgical setting (abdominal approach)
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman with a prior subtotal (supracervical) hysterectomy who presents months to years later with cervical stump symptoms such as persistent vaginal bleeding, pelvic pain, recurrent cervicitis, dyspareunia, or abnormal cervical pathology found on screening. Preoperative evaluation includes history and physical, pelvic exam, cervical cytology and/or biopsy as indicated, and imaging (pelvic ultrasound or MRI) to assess cervical stump anatomy and rule out adnexal pathology. The clinical workflow commonly involves preoperative counseling, medical optimization, anesthesia evaluation, and scheduling for an abdominal approach to cervical stump excision (amputation of the retained cervix) with concurrent pelvic floor repair as indicated. Intraoperative steps include abdominal exposure (open laparotomy or possible minimally invasive conversion depending on complexity), identification and excision of the cervical stump, hemostasis, and repair of any enterocele, cystocele, or rectocele if pelvic support defects are present. Postoperative care includes pain control, monitoring for bleeding or infection, activity restrictions, and follow-up for wound checks and pathology results. Typical facilities for this procedure are hospital operating rooms or ambulatory surgery centers with capabilities for general or regional anesthesia and inpatient recovery if needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, postoperative course | Use when the procedure is performed and the postoperative course is typical without complications. |