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    v1.0.30
    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Neck (Soft Tissues) and ThoraxCPT cpt-21685-hyoid-suspension-for-airway-management
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    CPT 21685: Hyoid Suspension for Airway Support

    Medicare pays $879 on average nationally for this procedure.

    CPT code 21685 describes a surgical procedure in which a provider incises muscle tissue around the hyoid bone and suspends or attaches the hyoid to another structure to support the tongue and improve airway patency for obstructive sleep apnea; this is an open surgical airway suspension procedure typically performed in an operating room or surgical suite as part of otolaryngology/head and neck surgery and is classified as a surgical service for airway stabilization.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old male with a history of moderate to severe obstructive sleep apnea (OSA) presents after failing conservative therapy including continuous positive airway pressure (CPAP) intolerance and mandibular advancement device trial. Polysomnography confirms obstructive events with oxygen desaturation and excessive daytime sleepiness. Examination and awake endoscopic evaluation demonstrate hypopharyngeal collapse with retroflexion of the tongue base and hyoid displacement contributing to airway obstruction. The surgical team (otolaryngology/head and neck surgery or oral and maxillofacial surgery) schedules the patient for a hyoid suspension procedure to advance and stabilize the hyoid bone and tongue base, improving airway patency.

    Preoperative workflow includes airway assessment, anesthesiology evaluation, informed consent, and completion of preoperative imaging or endoscopic documentation. Intraoperative steps commonly involve general anesthesia, a transcervical incision, dissection to the hyoid bone, optional myotomy of adjacent muscle (as indicated), placement of sutures or fixation devices to suspend the hyoid to the thyroid cartilage or mandible, and hemostasis. Postoperative workflow includes airway monitoring, pain control, swallow assessment, discharge planning with activity restrictions, and follow-up sleep medicine or otolaryngology visits to assess symptom improvement and potential need for adjunctive procedures.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    31600Tracheostomy, planned (separate procedure)May be performed for severe airway obstruction or as an alternative when other airway surgeries are inadequate.
    41825Excision and primary closure of benign lesion of oral mucosa, floor of mouth or tongue (e.g., partial glossectomy)May be performed when tongue base reduction or lesion removal is needed in conjunction with hyoid suspension.
    42145Partial glossectomy, anterior two-thirds of tongue, primary closurePerformed for tongue reduction procedures addressing tongue base obstruction as part of multilevel surgery for OSA.
    42820Tonsillectomy and adenoidectomy, combined (for adults/children)Tonsil/adenoid removal may be performed as adjunctive multilevel airway surgery for OSA.
    41826Submucosal resection or partial reduction of tongue base (e.g., radiofrequency, transoral)Minimally invasive tongue base procedures often combined with hyoid suspension to improve airway patency.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    208000000X
    2084P0800X
    284300000X
    207RA0001X
    261QH0100X
    101200000X
    163WM0705X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    F51.8Other sleep disorders not due to a substance or known physiological condition
    F51.9Sleep disorder not due to a substance or known physiological condition, unspecified
    G47.10Hypersomnia, unspecified
    G47.30Sleep apnea, unspecified
    G47.31Primary central sleep apnea
    G47.33Obstructive sleep apnea (adult) (pediatric)
    G47.34Idiopathic sleep related nonobstructive alveolar hypoventilation
    G47.39Other sleep apnea
    G47.9Sleep disorder, unspecified
    J34.0Abscess, furuncle and carbuncle of nose

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-21700-SCALENUS-ANTICUS-MUSCLE-DIVISION-NECK-RELEASE

    CPT 21700: Scalenus Anticus Muscle Division, Neck Surgery

    CPT-21705-SCALENUS-ANTICUS-MUSCLE-DIVISION-CERVICAL-RIB-REMOVAL

    CPT 21705: Scalenus Anticus Division with Cervical Rib Removal

    CPT-21720-STERNOCLEIDOMASTOID-MUSCLE-RELEASE-TORTICOLLIS

    CPT 21720: Sternocleidomastoid Muscle Division for Torticollis

    CPT-21725-STERNOCLEIDOMASTOID-RELEASE-FOR-TORTICOLLIS

    CPT 21725: Sternocleidomastoid Division for Torticollis

    CPT-21740-CHEST-WALL-RECONSTRUCTION-PECTUS-DEFORMITY-REPAIR

    CPT 21740: Chest Wall Reconstruction for Congenital Deformity

    CPT-21742-MINIMALLY-INVASIVE-CHEST-WALL-RECONSTRUCTION-PECTUS

    CPT 21742: Minimally Invasive Chest Wall Reconstruction

    CPT-21743-THORACOSCOPIC-CHEST-WALL-RECONSTRUCTION-PECTUS-REPAIR

    CPT 21743: Thoracoscopic Chest Wall Reconstruction

    CPT-21750-STERNAL-SEPARATION-CLOSURE-STERNAL-REPAIR

    CPT 21750: Closure of Sternal Separation

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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