Summary & Overview
CPT 21750: Closure of Sternal Separation
CPT code 21750 denotes surgical closure of a sternal separation arising from a previous sternotomy incision. The procedure addresses wound dehiscence, nonunion, or instability of the sternum after prior cardiac or thoracic surgery and is typically performed in an operating room setting, often during an inpatient episode. Nationally, this code captures a focused reconstructive chest-wall service that affects perioperative resource use, postoperative monitoring, and potential readmission risk.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is used, typical sites of service, and the types of surgical repair represented by this code. The summary highlights benchmarking considerations and policy-relevant billing elements that influence coverage and claim processing for sternal repair procedures. The content does not include payer-specific rates but outlines what to expect in claims documentation and coding practice for this surgical service.
This publication is intended to inform clinicians, coding professionals, and policy analysts about the clinical role of CPT code 21750, common operational settings, and the national payers that commonly process claims for this procedure. Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific reimbursement benchmarks.
Billing Code Overview
CPT code 21750 describes a surgical procedure to close a separation of the sternum (breast bone) that resulted from a prior median sternotomy incision. This service is surgical chest wall repair performed to reapproximate the sternal halves and restore chest wall stability after wound dehiscence or nonunion.
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Service type: Surgical repair of sternal separation
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Typical site of service: Hospital operating room or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A 62-year-old male patient returns to the cardiothoracic clinic six weeks after a median sternotomy for coronary artery bypass grafting with complaints of chest pain, palpable sternal instability, and occasional crepitus at the midline incision. Imaging (chest radiograph or CT) demonstrates separation of the sternal halves without active infection. The cardiothoracic surgeon evaluates wound healing, reviews prior operative notes, and schedules a procedure to close the sternal separation under general anesthesia. The typical workflow includes preoperative assessment, antibiotic prophylaxis as indicated, re-exposure of the previous incision, removal of fibrous tissue or nonviable material, re-approximation of sternal edges with wires, cables, or rigid fixation devices, verification of stability, layered soft tissue closure, and postoperative monitoring in a post-anesthesia care unit or inpatient cardiothoracic unit. Typical site of service is an operating room in an inpatient hospital or ambulatory surgical center depending on patient status. The service type is a surgical repair/re-approximation of the sternum following prior median sternotomy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Anesthesia: Not otherwise specified (carrier-specific) | Rarely used; include only if a payer requires this modifier for anesthesia reporting per policy |