CPT® Code 56632

The procedure described by CPT® Code 56632 refers to a radical partial vulvectomy combined with bilateral inguinofemoral lymphadenectomy. The vulva encompasses various structures of the external female genitalia, including the mons pubis, labia majora and minora, clitoris, vaginal vestibule, glands, urethral opening, and vaginal opening. A radical vulvectomy is a surgical intervention typically indicated for the treatment of invasive carcinoma affecting the vulva. This procedure is distinct from a simple vulvectomy, as it involves a more extensive excision that penetrates into the perineal fascia. In the context of CPT® Codes 56630 to 56632, the malignancy is localized to a portion of the vulva, necessitating the removal of only the affected area while ensuring that adequate margins of healthy tissue are preserved. The surgical approach involves careful marking of excision margins, followed by an incision through the skin down to the subcutaneous fat, with deep dissection extending to the perineal fascia and potentially into the periosteum of the pubic symphysis, depending on the extent of the disease. The excised tissue may include various structures based on the specific location of the malignancy, such as portions of the labia, vaginal vestibule, and associated glands. The procedure may also involve the removal of inguinofemoral lymph nodes, which is performed based on the presence and location of cancer, with bilateral lymphadenectomy indicated when the malignancy is centrally located. This comprehensive surgical approach aims to effectively manage the disease while minimizing the risk of recurrence.