2025 CPT code 56637
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Radical complete vulvectomy with bilateral inguinofemoral lymphadenectomy.
Modifiers may be applicable in certain situations, such as increased procedural services (22) or multiple procedures (51).
Medical necessity for 56637 is established by the presence of a malignant lesion of the vulva requiring radical resection for optimal treatment.
The physician performs a complete radical vulvectomy, including removal of all vulvar tissue and structures, and bilateral inguinofemoral lymphadenectomy.The procedure may also include removal of deep fascia of the thigh, lower abdominal area adjacent to the vulva, and/or the perineal area. The entire area may be removed en bloc.A Foley catheter is placed, and the patient is positioned in modified dorsal lithotomy. The excision area is marked, an incision is made, and the lymph nodes are identified and removed. All vulvar structures are removed down to the bone. Bleeding is controlled, and the defect may be closed with sutures or a skin graft. Drains may be placed.
In simple words: This surgery removes all of the vulvar tissue and the lymph nodes in both groins. It's done when there is cancer in the vulva.
This procedure involves the removal of the entire vulva (greater than 80%) and deep subcutaneous tissue, along with the lymph nodes in both groins. It is performed for malignant disease of the vulva.
Example 1: A patient with invasive squamous cell carcinoma of the vulva involving more than 80% of the vulvar area undergoes a radical complete vulvectomy with bilateral inguinofemoral lymphadenectomy (56637)., A patient with melanoma of the vulva involving over 80% of the vulvar area requires removal of the entire vulva and deep subcutaneous tissue. The inguinofemoral lymph nodes on both sides are also removed to check for metastasis (56637)., A 65-year-old female presents with vulvar cancer diagnosed as stage III. The tumor size is 5cm and involves the clitoris, both labia majora, and the perineum. She undergoes a radical complete vulvectomy with bilateral inguinofemoral lymphadenectomy. The procedure is coded as 56637.
Documentation should include details about the size and location of the tumor, the extent of vulvar involvement, operative details, including the extent of lymphadenectomy (inguinofemoral), and any reconstructive procedures performed.
** Harvesting of a graft for reconstruction is coded separately.If a lymph node biopsy is performed without complete lymphadenectomy, use 56633 and 38531.
- Revenue Code: P1G
- Payment Status: Active
- Specialties:Gynecologic Oncology, Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center