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CPT®
57330

CPT® Code 57330

Official Description

Closure of vesicovaginal fistula; transvesical and vaginal approach

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A vesicovaginal fistula (VVF) is a pathological condition characterized by an abnormal connection between the bladder and the vagina, resulting in the involuntary discharge of urine into the vaginal canal. This condition can arise due to various factors, including surgical complications, trauma, or prolonged labor during childbirth. The closure of a vesicovaginal fistula is a surgical procedure aimed at repairing this abnormal passage to restore normal urinary function and improve the quality of life for affected individuals. The procedure can be performed using different surgical approaches, including a vaginal approach or a combined transvesical and vaginal approach, as indicated by the CPT® Code 57330. In the combined approach, the surgeon makes incisions in both the abdomen and vagina to access and excise the fistula, ensuring that surrounding scar tissue is also removed to promote optimal healing. This comprehensive method allows for effective closure of the fistula and repair of any associated defects in the bladder and vaginal walls.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closure of a vesicovaginal fistula using CPT® Code 57330 is indicated for patients presenting with the following conditions:

  • Vesicovaginal Fistula An abnormal passage between the bladder and vagina that leads to urinary leakage.
  • Urinary Incontinence Resulting from the presence of the fistula, causing significant distress and hygiene issues.
  • Post-Surgical Complications Following pelvic surgery or childbirth that may have led to the formation of the fistula.

2. Procedure

The procedure for the closure of a vesicovaginal fistula using a combined transvesical and vaginal approach involves several critical steps:

  • Step 1: Abdominal Incision The surgeon begins by making an incision in the abdomen to access the bladder. This step is crucial for visualizing and manipulating the bladder during the procedure.
  • Step 2: Cystotomy Once the bladder is exposed, a cystotomy is performed, which involves opening the bladder to allow for direct access to the fistula. This step is essential for identifying the fistula and surrounding scar tissue.
  • Step 3: Catheterization of Ureters The ureters are catheterized to ensure that urine flow is managed during the procedure and to prevent any injury to the ureters while excising the fistula.
  • Step 4: Identification and Excision of the Fistula The fistula is carefully identified and excised along with any surrounding scar tissue. This step is critical to ensure complete removal of the abnormal tissue and to promote healing.
  • Step 5: Vaginal Incision A second incision is made in the vagina to access any remaining fistula tissue. The surgeon dissects the tissue free from surrounding structures and excises it to ensure complete closure of the fistula.
  • Step 6: Closure of Vaginal Defect The vaginal defect is then closed, which may be done through either the abdominal or vaginal route, depending on the location of the defect.
  • Step 7: Closure of Bladder and Fascia The defects in the bladder wall and fascia are closed using an abdominal approach, ensuring that the integrity of the bladder is restored.
  • Step 8: Removal of Ureteral Catheters After ensuring that the surgical site is secure, the ureteral catheters are removed, and the cystotomy is closed to complete the procedure.

3. Post-Procedure

Post-procedure care following the closure of a vesicovaginal fistula includes monitoring for any signs of complications such as infection or urinary leakage. Patients may require a catheter for a period to allow the bladder to heal properly. Follow-up appointments are essential to assess the surgical site and ensure that the fistula has been successfully closed. Patients are typically advised on activity restrictions and may need to follow specific guidelines regarding fluid intake and urinary habits during the recovery phase.
Short Descr REPAIR BLADDER-VAGINA LESION
Medium Descr CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR
Long Descr Closure of vesicovaginal fistula; transvesical and vaginal approach
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 112 - Other OR therapeutic procedures of urinary tract
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
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Pre-1990 Added Code added.
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