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2025 CPT code 57267

Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach.

This is an add-on code and cannot stand alone. It must accompany a primary procedure code for vaginal wall repair.Medical necessity for mesh augmentation must be documented.

Modifiers are not typically appended to this add-on code.

Documentation must clearly show that the patient's pelvic floor is weakened to the point where sutures alone are insufficient for a successful repair, necessitating the use of mesh for adequate support.

The surgeon performs the graft insertion as part of a larger vaginal wall surgery. This involves measuring and cutting the graft material, placing sutures to secure it, removing excess tissue, irrigating, closing the area, and packing the vagina.

IMPORTANT:This code must be used with codes 45560, 57240, 57250, 57260, 57265, and 57285.

In simple words: The doctor inserts a mesh patch to strengthen a weak area of the vaginal wall. This is an additional procedure done along with another main procedure.

This CPT code represents the insertion of a prosthetic graft over the anterior or posterior vaginal wall to address insufficient tissue strength.The procedure involves a vaginal approach and is considered an add-on code, requiring use in conjunction with a code for the primary procedure. The surgeon sizes the graft, secures it with sutures deep within the pelvis and to the levator muscles and vaginal walls, removes excess vaginal tissue, irrigates the site, closes any remaining tissue with running sutures, and packs the vagina with gauze.

Example 1: A patient presents with a cystocele (bladder prolapse) and requires an anterior colporrhaphy (repair of the anterior vaginal wall).During the procedure, the surgeon also notes weakened vaginal tissue and inserts mesh using code 57267 in addition to the primary repair code., A patient undergoes a posterior colporrhaphy (repair of the posterior vaginal wall) for a rectocele (rectal prolapse). The surgeon determines that additional support is needed and uses mesh to reinforce the posterior vaginal wall, billing 57267 in conjunction with the primary procedure code., A patient has both a cystocele and rectocele requiring an anterior and posterior colporrhaphy. The surgeon uses mesh reinforcement on both anterior and posterior compartments and bills 57267 twice, one for each compartment.

Detailed operative notes describing the need for mesh insertion due to weak vaginal tissue, the location of mesh placement (anterior, posterior, or both), type of mesh used, and the surgical technique employed.

** Payers may scrutinize medical necessity for the mesh. Ensure complete and clear documentation supporting the need for mesh augmentation.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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