CPT 21743: Thoracoscopic Chest Wall Reconstruction for Pectus Deformity

CPT code 21743 represents thoracoscopic chest wall reconstruction for congenital deformities such as pectus excavatum and pectus carinatum. The code captures a minimally invasive approach using a thoracoscope to visualize and repair sunken or protruding sternum deformities. Nationally, this code is relevant to pediatric and thoracic surgical services, surgical resource planning, and payer coverage determinations for corrective chest wall procedures.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the common payer landscape affecting coverage. The publication also outlines benchmarks for utilization, relevant policy updates affecting authorization and coding practice, and clinical considerations that influence billing and site-of-service decisions.

This summary is intended for healthcare administrators, coding professionals, and policy analysts seeking a clear national perspective on how CPT code 21743 is used, reimbursed, and managed across major payers. Data not available in the input has been omitted from this summary.

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Billing Code Overview

CPT code 21743 describes a minimally invasive surgical reconstruction of the chest wall to repair congenital deformities such as pectus excavatum (sunken chest) or pectus carinatum (protruding sternum). The procedure is performed through small thoracoscopic incisions, with insertion of a thoracoscope — an instrument carrying a video camera — to permit visualization of the interior chest during repair.

Service type: Thoracoscopic chest wall reconstruction for congenital deformity repair

Typical site of service: Hospital operating room or specialized ambulatory surgical center

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CPT 21743: Thoracoscopic Chest Wall Reconstruction for Pectus Deformity

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Billing Code Overview

Service type: Thoracoscopic chest wall reconstruction for congenital deformity repair

Typical site of service: Hospital operating room or specialized ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A 16-year-old adolescent male with symptomatic pectus excavatum presents to a pediatric thoracic surgery clinic for evaluation. He reports progressive exercise intolerance, exertional dyspnea, and chest wall pain with body image concerns. Physical exam demonstrates a marked sternal depression. Preoperative workup includes chest radiograph, chest computed tomography to evaluate severity and cardiac compression, pulmonary function testing, and cardiology evaluation. After multidisciplinary discussion, the patient is scheduled for minimally invasive repair of pectus excavatum with thoracoscopic assistance.

The clinical workflow includes preoperative clearance (history and physical, labs, imaging, anesthesia evaluation), operative procedure performed in an operating room with general endotracheal anesthesia and single-lung ventilation as needed, insertion of a thoracoscope through small lateral chest wall incisions, mobilization and elevation of the depressed sternum with placement of corrective bars or sutures, intraoperative thoracoscopic visualization to avoid cardiac or pulmonary injury, closure of incisions, and postoperative monitoring in the PACU with admission for analgesia and respiratory support. Follow-up includes wound checks, pain management, activity restrictions, and planned hardware removal if applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`21743`	Reconstruction of chest wall using small incisions with thoracoscopic assistance (pectus excavatum/carinatum repair)	Primary procedure for minimally invasive repair of congenital chest wall deformities
`19350`	Nipple/areola reconstruction (not directly related to pectus repair)	Data not available in the input.
`32551`	Tube thoracostomy, includes insertion of chest tube	Often performed postoperatively for pleural drainage if pneumothorax or pleural effusion anticipated
`31600`	Bronchoscopy, diagnostic, flexible or rigid	May be performed intraoperatively or preoperatively for airway assessment if indicated
`11043`	Debridement, skin, subcutaneous tissue, muscle and fascia (extensive)	Used if extensive soft tissue management or debridement required during chest wall reconstruction
`26010`	Drainage or excision of deep-seated lesion of chest wall (example)	Data not available in the input.

Related Modifiers

12 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
26	Modifier 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…
50	Modifier –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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
78	CPT 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	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207P00000X	Emergency Medicine Physician	An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
213ES0131X	Foot Surgery Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
261QC0050X	Critical Access Hospital Clinic/Center	An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary ca…
2279G0305X	Geriatric Care Registered Respiratory Therapist	Care of older patients who have age and/or disease related decremental pulmonary changes. Diagnosis and treatment is very important for this group si…
207QA0000X	Adolescent Medicine (Family Medicine) Physician	A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their …
1835C0206X	Cardiology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in direct patient care to ensure safe and effective use of medications in p…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
E83.52	Hypercalcemia
J96.00	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20	Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J98.4	Other disorders of lung
M32.9	Systemic lupus erythematosus, unspecified
M34.9	Systemic sclerosis, unspecified
M80.00XA	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
M81.0	Age-related osteoporosis without current pathological fracture
M95.0	Acquired deformity of nose
M95.2	Other acquired deformity of head

Showing 1–10 of 26

CPT 21685: Hyoid Suspension for Airway Management

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

CPT 21700: Scalenus Anticus Muscle Division for Neck Nerve Compression

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

CPT 21705: Scalenus Anticus Muscle Division with Cervical Rib Removal

CPT-21720-STERNOCLEIDOMASTOID-MUSCLE-RELEASE-TORTICOLLIS

CPT 21720: Sternocleidomastoid Muscle Release for Torticollis

CPT-21725-STERNOCLEIDOMASTOID-RELEASE-FOR-TORTICOLLIS

CPT 21725: Sternocleidomastoid Release for Torticollis

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

CPT 21740: Chest Wall Reconstruction for Pectus Deformity Repair

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

CPT 21742: Minimally Invasive Chest Wall Reconstruction for Pectus Deformities

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

CPT 21750: Closure of Sternal Separation

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`21743`	Reconstruction of chest wall using small incisions with thoracoscopic assistance (pectus excavatum/carinatum repair)	Primary procedure for minimally invasive repair of congenital chest wall deformities
`19350`	Nipple/areola reconstruction (not directly related to pectus repair)	Data not available in the input.
`32551`	Tube thoracostomy, includes insertion of chest tube	Often performed postoperatively for pleural drainage if pneumothorax or pleural effusion anticipated
`31600`	Bronchoscopy, diagnostic, flexible or rigid	May be performed intraoperatively or preoperatively for airway assessment if indicated
`11043`	Debridement, skin, subcutaneous tissue, muscle and fascia (extensive)	Used if extensive soft tissue management or debridement required during chest wall reconstruction
`26010`	Drainage or excision of deep-seated lesion of chest wall (example)	Data not available in the input.

Related Modifiers

12 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
26	Modifier 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…
50	Modifier –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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
78	CPT 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	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207P00000X	Emergency Medicine Physician	An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
213ES0131X	Foot Surgery Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
261QC0050X	Critical Access Hospital Clinic/Center	An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary ca…
2279G0305X	Geriatric Care Registered Respiratory Therapist	Care of older patients who have age and/or disease related decremental pulmonary changes. Diagnosis and treatment is very important for this group si…
207QA0000X	Adolescent Medicine (Family Medicine) Physician	A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their …
1835C0206X	Cardiology Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in direct patient care to ensure safe and effective use of medications in p…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
E83.52	Hypercalcemia
J96.00	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20	Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J98.4	Other disorders of lung
M32.9	Systemic lupus erythematosus, unspecified
M34.9	Systemic sclerosis, unspecified
M80.00XA	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
M81.0	Age-related osteoporosis without current pathological fracture
M95.0	Acquired deformity of nose
M95.2	Other acquired deformity of head

Showing 1–10 of 26

CPT 21685: Hyoid Suspension for Airway Management

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

CPT 21700: Scalenus Anticus Muscle Division for Neck Nerve Compression

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

CPT 21705: Scalenus Anticus Muscle Division with Cervical Rib Removal

CPT-21720-STERNOCLEIDOMASTOID-MUSCLE-RELEASE-TORTICOLLIS

CPT 21720: Sternocleidomastoid Muscle Release for Torticollis

CPT-21725-STERNOCLEIDOMASTOID-RELEASE-FOR-TORTICOLLIS

CPT 21725: Sternocleidomastoid Release for Torticollis

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

CPT 21740: Chest Wall Reconstruction for Pectus Deformity Repair

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

CPT 21742: Minimally Invasive Chest Wall Reconstruction for Pectus Deformities

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

CPT 21750: Closure of Sternal Separation

References

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.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.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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CPT 21743: Thoracoscopic Chest Wall Reconstruction for Pectus Deformity

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Billing Code Overview

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CPT 21743: Thoracoscopic Chest Wall Reconstruction for Pectus Deformity

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References