2025 CPT code 21602
(Active) Effective Date: N/A Revision Date: N/A Surgery - Chest Wall Procedures Musculoskeletal System Feed
Excision of chest wall tumor involving ribs, with plastic reconstruction; without mediastinal lymphadenectomy.
Modifiers may be required depending on the circumstances of the procedure, including but not limited to modifiers 51 (multiple procedures), 59 (distinct procedural service), and 76 (repeat procedure).Always consult the most recent CPT guidelines and specific payer requirements for appropriate modifier use.
Medical necessity is established by the presence of a chest wall tumor requiring surgical resection.Reconstruction is medically necessary to restore structural integrity and function of the chest wall, minimizing the risk of respiratory compromise, pain, and deformity.
The surgeon is responsible for the complete procedure, including tumor excision, chest wall reconstruction, and wound closure.Anesthesiologist and possibly other specialists may also be involved.
In simple words: The doctor removes a tumor from the chest wall, including one or more ribs.After removing the tumor, the doctor repairs the area using skin, muscle, and possibly bone grafts or artificial materials to restore the chest wall's shape and function.The doctor does not remove any lymph nodes in the chest.
This CPT code encompasses the surgical excision of a chest wall tumor that involves one or more ribs.The procedure includes resection of the tumor and any involved portions of the rib(s), followed by plastic reconstruction of the chest wall defect using techniques such as myocutaneous flaps and/or bone grafts or prosthetic materials.Mediastinal lymphadenectomy (removal of lymph nodes in the mediastinum) is not included.
Example 1: A 60-year-old male presents with a palpable mass on his right anterior chest wall. Imaging reveals a chondrosarcoma involving the 4th and 5th ribs.The surgeon performs a wide excision of the tumor and involved ribs, reconstructing the chest wall using a latissimus dorsi myocutaneous flap and a rib graft., A 45-year-old female with a history of breast cancer presents with chest wall recurrence involving the 2nd rib.The surgeon performs en bloc resection of the tumor and rib, reconstructing the chest wall using a prosthetic mesh and methylmethacrylate., A 72-year-old male is diagnosed with a fibrosarcoma of the sternum. The surgeon performs a wide local excision of the tumor and adjacent ribs.Reconstruction is done using a pectoralis major myocutaneous flap and prosthetic material.
Preoperative imaging (CT scan, MRI), pathology report confirming diagnosis and margins, operative report detailing the extent of resection and reconstruction, postoperative imaging (if applicable), and any relevant pathology reports from lymph node biopsies (if performed).
** The choice of reconstruction materials and techniques will vary depending on the extent of resection, patient factors, and surgeon preference.Always ensure comprehensive and accurate documentation to support the code reported. This information is for general guidance only.Always refer to the most up-to-date CPT guidelines and payer-specific policies.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information requires consultation of a specific fee schedule and may vary by payer and location.
- Global Days: The global period for this procedure will vary depending on the complexity of the surgery and the payer's guidelines.Refer to specific payer guidelines for details.
- Payment Status: Active
- Modifier TC rule: This code does not have a technical component (TC) modifier.
- Fee Schedule: Historical fee schedule information should be obtained from a reliable source such as a commercial medical billing database.
- Specialties:Thoracic Surgery, Plastic Surgery, Oncology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center