(2023) Labiaplasty CPT Code 56620 | Description, Guidelines, Reimbursement, Modifiers & Examples

Labiaplasty CPT code 56620 is billed for a service when the Physician performs labiaplasty or simple partial Vulvectomy. The Physician performs surgery to remove all or part of the external components of a woman’s genitals, such as precancerous or cancerous tissue.

Description Of Labiaplasty CPT Code 56620

The Physician performs labiaplasty to lower or augment the size of the patient’s labia. This procedure aims to enhance the appearance of labia or reduce physical discomfort.

The following are the reasons why the Physician performs labiaplasty:

• To lower the size of labia minora to avoid the superimposition of labia majora.
• To boost hygiene and health.
• To improve comfort, confidence, and sexual well-being.
• To increase self-confidence and eliminate visual lines.
• To reduce unevenness of the labia minora or labia majora.
• To rebuild a more youthful look after childbirth or aging.

The official description of the 56620 CPT code is: “Vulvectomy simple; partial.”

The Physician eliminates part or all of the vulva to treat premalignant or malignant lesions. A complete vulvectomy removes all labia majora, labia minora, and clitoris.

In contrast, a simple, partial vulvectomy may consist of removing part or all of the labia minora or labia majora on one side and the clitoris.

The Physician explores the lower genital tract and the perianal skin through a colposcope. In Labiaplasty CPT code 56620, a wide semi-elliptical incision contains the diseased area. 

The Physician removes the underlying subcutaneous fatty tissue and a substantial portion of excised skin. Vessels clamp and tie off with sutures or are electro-coagulated to control bleeding. The significant defect is usually closed in layers using separately reportable plastic techniques. Vaginal gauze packing incorporates into the vagina.

Reimbursement  

A maximum of one unit can be a bill on the same service date of CPT 56620. In contrast, the Two units allow documentation supporting the service’s medical necessity. 

The cost and RUVS of Labiaplasty CPT code 56620 are $660.97 and 19.09962 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 56620 are $660.97 and 19.09962 when performed in the non-facility. 

Billing Guidelines 

CPT 56620 includes removal; if the Physician removes the area Greater than 80% vulvar area, it will be the complete procedure.

If the Physician removes the less than 80% vulvar area, 56620 will be a partial procedure.

If the Physician removes skin and deep subcutaneous tissue, the 56620 CPT code will be a radical procedure.

It will be a simple procedure if the Physician removes skin and superficial subcutaneous tissues.

If a Skin graft (15004-15005, 15120-15121, 15240-15241) performs in combination with Labiaplasty CPT code 56620, It is appropriate to report skin grafts separately.

CPT code 56620 has a 90-day global period. If any Evaluation and management (E/M) service performs with CPT code 56620, modifier 24 will report with E/M service for an unrelated condition. 

Suppose the E/M visit is for postoperative care of a prior surgical procedure if the patient sees an unrelated condition on the exact procedure date. In that case, it is not appropriate to report the E/M code with 56620 separately during the global period. While modifier 25 will be applicable with CPT code 56620. 

Billing Example

The following is the example of when Labiaplasty CPT code 56620 can be reported:

A 25-year-old female presents with uneven labia minora and Majora. The patient had no other symptoms and itching in the female genital area. 

The physical exam revealed swelling in the female genital organs. The Physician ordered an X-ray of the pelvis.

 It shows no skin infections around the female genital organs. The patient denies other symptoms, such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath. 

The Physician ordered labiaplasty to prevent infection in the future and prescribes mediation. The insurance may not reimburse the reason for this encounter as a cosmetic reason because the patient did not have any complaints.

Because the Physician ordered labiaplasty, CPT 56620 was billed.