Summary & Overview
CPT 21230: Autogenous Rib Cartilage Graft for Facial Reconstruction
CPT code 21230 represents the surgical placement of an autogenous rib cartilage graft to the face (chin, nose, or ear) for correction of deformity from fracture, trauma, tumor resection, or congenital anomalies. It is a reconstructive procedure that addresses both functional and aesthetic defects and is clinically significant across plastic surgery, otolaryngology, and maxillofacial practices nationwide. The code matters nationally because it captures resource use for complex reconstructive work, influences surgical care pathways, and affects payer coverage and authorization processes.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service (operating room or ambulatory surgical center), and expected service type (surgical reconstructive grafting of facial cartilage). The publication also summarizes payer coverage patterns and benchmark considerations where available, highlights any recent policy or reimbursement updates relevant to reconstructive cartilage grafting, and explains how this code fits into surgical care workflows. Data not available in the input will be identified as such in appropriate sections.
Billing Code Overview
CPT code 21230 describes the application of an autogenous cartilage graft harvested from the patient’s own rib to the face — including the chin, nose, or ear — to repair deformity caused by fracture, injury, tumor resection, or congenital defect (for example, saddle nose deformity).
Service type: Surgical reconstructive grafting of facial cartilage
Typical site of service: Operating room or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient presents with a post-traumatic nasal deformity (saddle nose) after a motor vehicle collision that caused collapse of the nasal dorsum and septal support. The reconstructive surgeon plans an open rhinoplasty with structural support using autogenous costal cartilage graft harvested from the patient’s own rib to rebuild the nasal framework and correct nasal airway compromise and cosmetic deformity. Preoperative workup includes history and physical, facial imaging as indicated, informed consent addressing donor-site morbidity, and anesthesia evaluation. The procedure is performed in an operating room; after induction of general anesthesia, the surgeon harvests a segment of costal cartilage, sculpts the graft on the back table, performs open nasal exposure, repairs the deformity by placing the autogenous cartilage graft for dorsal augmentation and septal support, achieves hemostasis, and closes both donor and recipient sites. Postoperative care includes monitoring in the post-anesthesia care unit, pain control for both chest and nasal sites, wound care instructions, and follow-up visits to assess graft integration, airway function, and aesthetic outcome.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for 21230 and documentation supports additional reimbursement. |