Summary & Overview
CPT 21360: Repair of Depressed Zygomatic (Cheekbone) Fracture
CPT code 21360 denotes open surgical repair of a depressed zygomatic (cheekbone) fracture approached through a skin incision. This code captures definitive operative management for blunt-force injuries that produce depression and contour deformity of the cheekbone, with implications for facial symmetry, ocular function, and mastication. Nationally, surgical repair codes for facial fractures are important for trauma, oral-maxillofacial, and plastic surgery practices and for payers managing acute injury care and post-operative outcomes.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the service, the typical sites where it is delivered, and which payers are commonly involved. The publication provides benchmarks and billing context relevant to hospital and outpatient surgical settings, highlights coding and documentation points that influence coverage decisions, and outlines the clinical scenarios in which this code is applied. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 21360 describes the surgical repair of a depressed fracture of the zygomatic (cheek) bone caused by blunt force trauma. The procedure is performed by creating a skin incision to access and reduce the depressed fracture and restore facial contour and function.
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Service type: Open surgical repair of facial bone fracture performed through a skin incision
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Typical site of service: Hospital operating room or outpatient surgical center depending on injury severity and patient condition
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after an assault with blunt facial trauma. He has facial pain, swelling, periorbital ecchymosis, infraorbital numbness, and visible depression of the left zygomatic bone. CT facial bones confirms a depressed left zygomaticomaxillary complex fracture with step-off of the zygomatic arch and displacement affecting orbital rim alignment. The patient is evaluated by an oral and maxillofacial surgeon and cleared for operative management under general anesthesia. The clinical workflow includes preoperative imaging review, informed consent, operative planning for open reduction and internal fixation, skin incision directly over the fracture site to access and elevate the depressed zygoma, fixation with plates and screws as indicated, intraoperative assessment of orbital and occlusal alignment, and postoperative radiographs. Typical perioperative documentation captures indication, operative approach, estimated blood loss, implants used, complications, and follow-up instructions. Typical patient factors include acute traumatic injury, otherwise healthy adults, and possible comorbidities affecting anesthesia risk. Typical site of service is an operating room in an acute care hospital or ambulatory surgical center when appropriate. Service type is open surgical repair of a depressed cheekbone (zygomatic) fracture performed through a skin incision (21360).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |