In simple words: This procedure removes one to four non-cancerous fibroid tumors from the uterus through the vagina. The fibroids must weigh less than 250 grams total. The procedure is done under general anesthesia and involves specialized instruments to access and remove the fibroids while preserving the uterus.

This procedure involves the excision of one to four intramural uterine fibroids with a total weight of 250 grams or less, and/or removal of surface myomas, via a vaginal approach. The patient is placed in a lithotomy position under general anesthesia. A weighted speculum is inserted into the vagina, and the cervix is grasped with a tenaculum. Prolapsing fibroids are grasped and brought out of the cervix. The fibroid stalk may be twisted to break it from the uterine wall or a wire loop electrode may be used to cut around the stalk or excise embedded fibroids. A vaginal speculum is used to maintain vaginal opening and separation of the vaginal wall. The vaginal mucosa is incised, and the endopelvic fascia is separated to expose the peritoneum. The uterine wall is identified by dissecting the vesicouterine space and may be incised to the level of the fibroids. The fibroids are then excised. The uterine wall is closed with sutures, and all instruments are withdrawn. This code also applies to the removal of surface benign neoplasms of muscular tissue.

Example 1: A 35-year-old woman presents with heavy menstrual bleeding and pelvic pressure. Examination reveals two intramural fibroids totaling 150 grams. The physician performs a vaginal myomectomy to remove the fibroids., A 40-year-old woman has three small submucosal fibroids causing irregular bleeding. A vaginal myomectomy is performed to remove the fibroids via a hysteroscopic approach., A 45-year-old woman with a prolapsing fibroid extending through the cervix undergoes a vaginal myomectomy to excise the fibroid without requiring an abdominal incision.

Documentation should include the size, number, location, and total weight of fibroids removed, operative details including the approach and techniques used, and any complications encountered. Pre-operative imaging and pathology reports should also be included.