CPT Code 57720 Billing and Coding Guide for Repair Procedures on the Cervix Uteri

Accurate CPT coding remains a cornerstone of compliant OBGYN billing and effective reimbursement. CPT 57720 is used to report the plastic repair of the introitus (vaginal opening), a procedure performed to correct narrowing, deformity, or trauma-related defects. This repair may be required following childbirth, injury, or previous surgery that has altered the vaginal entrance, causing pain, dyspareunia, or functional impairment.

This 2025 coding guide provides detailed insight into the correct application of CPT 57720, following the latest AAPC and CMS guidelines, ensuring OBGYN providers document and bill appropriately for this reconstructive procedure.

CPT 57720 – Description

Official Definition: “Plastic repair of introitus.”

This code describes the surgical reconstruction or revision of the vaginal introitus, which may include excision of scar tissue, realignment of tissue planes, and re-creation of a normal anatomic opening. It is performed to restore normal vaginal function, relieve discomfort, and improve cosmetic or structural outcomes.

Key Highlights:

• Primarily indicated for postpartum introital narrowing, scar contracture, or traumatic deformity.
• Includes simple reconstruction with tissue rearrangement and closure.
• Does not include perineorrhaphy or vaginal wall repair (use 57250–57260 if applicable).

When to Use CPT 57720

CPT 57720 should be reported when the surgical intent is to restore the normal size, shape, and function of the vaginal introitus due to pathological or traumatic changes.

Typical clinical indications include:

• Scarring or stenosis after vaginal delivery.
• Dyspareunia due to a tight or scarred vaginal opening.
• Post-surgical deformity following episiotomy or perineal repair.
• Traumatic introital lacerations are not healing properly.
• Functional narrowing is causing difficulty with intercourse or pelvic examination.

Do not report 57720 for:

• Cosmetic vaginal tightening without medical necessity.
• Repair limited to the perineum (use 56810 or 56800 as appropriate).
• Extensive pelvic reconstruction procedures (use 57260–57265).

Coding Guidelines and Compliance For CPT 57720

Per AAPC and CMS 2025 instructions:

• Report once per operative session, regardless of the number of introital defects repaired.
• The procedure includes local tissue rearrangement and closure; do not bill separately for simple debridement or scar excision.
• Carries a 90-day global period, encompassing postoperative care.
• Anesthesia, pathology, and related services may be reported separately when appropriately documented.
• Ensure medical necessity is clearly established in cases involving pain, scarring, or functional impairment to avoid payer denials.

Reimbursement Overview

CPT 57720 – 2025 Payment Data

• Global period: 90 days
• Typical service location: Hospital or Ambulatory Surgical Center (ASC)
• Average Medicare reimbursement: ~$700 – $850 (region-dependent)
• ASC facility rate: ~$450 – $550

Private insurance carriers may have variable coverage for reconstructive procedures. Documentation must confirm that the repair was therapeutic, not cosmetic, and linked to a valid diagnosis such as vaginal stenosis (N89.5) or dyspareunia (N94.10).

Modifier Use

Modifiers help clarify procedural circumstances and billing responsibility. For CPT 57720, consider:

• Modifier 22 – For unusually complex repair involving extensive scarring or tissue loss.
• Modifier 51 – If performed with another major gynecologic surgery.
• Modifier 59 (or XU) – When performed separately from other vaginal or perineal repairs.
• Modifier 54 / 55 – For shared surgical and postoperative management.
• Modifier 52 – If the repair is limited or partial compared to a standard plastic revision.

Each modifier should be backed by clear operative details to ensure claim accuracy and prevent payer rejections.

Documentation Requirements

For CPT 57720, operative documentation must clearly reflect surgical necessity, technique, and outcome. Key elements include:

• Preoperative diagnosis: Introital stenosis, painful scarring, or deformity.
• Extent of repair: Size of defect, tissue excised, and reconstruction approach.
• Surgical steps: Excision, mobilization, and layered closure details.
• Functional rationale: Pain relief, restoration of anatomy, or correction of trauma.
• Specimen handling: If tissue is sent for pathology, note details.
• Postoperative care: Recovery instructions and expected healing plan.

Clear, complete notes support compliance and protect against audit risk.

Example Scenarios

Scenario 1:

A 45-year-old patient presents with introital scarring and dyspareunia after multiple childbirths. The physician performs surgical excision and reconstruction of the vaginal opening. → Report CPT 57720.

Scenario 2:

Patient undergoes plastic repair of the introitus concurrently with posterior vaginal wall repair. → Report 57720 and 57250, with modifier 51 for multiple procedures.

Scenario 3:

Limited scar excision without reconstruction. → Report 11420–11426, depending on excision depth and size.

BillingFreedom – Specialized Expertise in OBGYN Medical Billing

BillingFreedom provides end-to-end OBGYN medical billing services designed for surgical and reconstructive procedures like CPT 57720. Our certified coding team ensures strict adherence to AAPC and CMS 2025 compliance standards, guaranteeing accurate code assignment and payer-specific claim submission.

By integrating deep procedural knowledge with real-time billing analytics, BillingFreedom helps OBGYN practices minimize denials, improve reimbursement turnaround, and maintain audit-ready documentation. We ensure your billing operations remain efficient and compliant, allowing your providers to focus solely on patient outcomes.

For more details about our exceptional OB/GYN billing services, please don't hesitate to contact us via email at info@billingfreedom.com or call us at +1 (855) 415-3472.

Your financial tranquility is our priority!