2025 CPT code 57295
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Revision (including removal) of a prosthetic vaginal graft using a vaginal approach.
Modifiers may be necessary to reflect reduced services (-52), anesthesia provided by surgeon (-47), or unplanned return to the operating room for a related procedure (-78).Consult the NCCI edits for appropriate modifiers.
Medical necessity is established by documentation of symptoms related to the previously placed mesh (e.g., pain, infection, exposure, erosion) that require surgical intervention.The documentation must support the need for the specific type and extent of the procedure performed.
The physician is responsible for patient positioning, anesthesia administration (if applicable), surgical technique, wound closure, insertion of Foley catheter, and vaginal packing.Post-operative care is also the physician's responsibility.
In simple words: This code covers a surgery to fix or remove a mesh that was previously placed in the vagina. The mesh might need to be fixed or taken out if it's causing problems such as erosion or exposure.
This CPT code encompasses the surgical revision or removal of a previously placed prosthetic vaginal graft via a vaginal approach.The procedure is indicated when the graft has eroded, the overlying tissue has thinned exposing the mesh, or other complications necessitate its revision or removal. The procedure involves placing the patient in the dorsal lithotomy position, administering anesthesia, inserting a speculum for visualization, assessing the graft's condition, and either revising it by excising surrounding tissue or completely excising it.The endopelvic fascia and vaginal mucosa are then closed, a Foley catheter is inserted, and the vagina is packed with gauze.
Example 1: A patient presents with erosion of a previously placed polypropylene vaginal mesh graft. The surgeon performs a vaginal approach to excise the eroded portion of the mesh and close the defect., A patient experiences vaginal pain and discomfort due to a thinned vaginal wall overlying a previously implanted mesh. The surgeon removes the entire mesh via a vaginal approach and closes the vaginal mucosa and endopelvic fascia., A patient has a partially exposed mesh graft following a previous pelvic reconstructive surgery. The surgeon revises the graft by excising the surrounding tissue to rebury the mesh, and then closes the vaginal mucosa.
Operative report detailing the approach (vaginal), type of graft, extent of revision or removal, closure technique, use of anesthesia, and any complications encountered.Preoperative and postoperative diagnoses should be documented as well.
** This code should not be used for simple removal of excess mesh material in the office setting without anesthesia.If the surgeon chooses to replace the graft with a new graft during this procedure, the replacement is included as part of the revision.If a simple office procedure with removal of excess material is performed, another appropriate code (e.g., 10120 with modifier -52) should be used. Always refer to the most up-to-date CPT manual and NCCI edits for accurate coding.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: The RVUs for this code are significantly higher when performed in the hospital setting compared to the office setting.The specific RVUs vary based on the geographical location and payer.
- Global Days : This procedure has a 90-day global period.Any related services within this period are typically included in the initial payment unless specific modifiers are applied.
- Payment Status: Active
- Modifier TC rule: This code does not typically involve a technical component (TC) modifier.
- Fee Schedule : Historical fee schedule data is not provided but will vary by payer, location, and year.
- Specialties:Urogynecology, Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office