Summary & Overview
CPT 30435: Intermediate Revision Rhinoplasty with Osteotomy
CPT code 30435 denotes an intermediate revision rhinoplasty that includes cutting the nasal bone (osteotomy) and is used when a patient requires corrective surgery after a prior rhinoplasty. This code captures a commonly performed reconstructive and cosmetic-surgical service that carries implications for coverage policy, prior authorization, and clinical documentation nationally. Payers commonly addressing this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for revision rhinoplasty, typical settings where the procedure is performed, and the key payer landscape. The publication summarizes benchmarks related to utilization and coverage tendencies, highlights relevant policy considerations that affect claims adjudication (such as medical necessity and cosmetic-versus-reconstructive determinations), and outlines documentation elements that payers frequently require. Data not available in the input will be noted where applicable. The piece is intended to help billing, coding, and policy staff quickly understand what CPT code 30435 represents, why it matters at a national level, and what to expect from major payers when managing claims for intermediate revision rhinoplasty with osteotomy.
Billing Code Overview
CPT code 30435 describes an intermediate revision rhinoplasty with osteotomy performed on a patient who has previously undergone rhinoplasty. The procedure involves surgical revision of the nasal structure that includes cutting the nasal bone to correct form or function after a prior rhinoplasty.
Service type: Surgical — Revision Rhinoplasty (Intermediate, with osteotomy)
Typical site of service: Hospital operating room or ambulatory surgery center, where surgical facilities and general anesthesia or monitored anesthesia care are available for nasal reconstructive procedures.
Clinical & Coding Specifications
Clinical Context
A 38-year-old patient presents to a facial plastic surgeon for evaluation of persistent cosmetic and functional deformity following prior rhinoplasty. The patient reports nasal airway obstruction on exertion and visible dorsal irregularity with residual bony deviation from prior surgery performed two years earlier. Physical exam demonstrates external nasal asymmetry, narrowed internal nasal valve on one side, and palpable step-off over the nasal bones. CT of the paranasal sinuses confirms residual bony deviation without acute sinus disease. After conservative measures fail and shared decision-making, the surgeon schedules an intermediate revision rhinoplasty involving osteotomies (cutting the nasal bones) to correct the bony vault and improve both form and function.
The typical clinical workflow includes preoperative evaluation and imaging, documentation of prior operative history and current anatomic findings, informed consent that specifies revision rhinoplasty and osteotomy, intraoperative performance of open or closed rhinoplasty techniques with controlled nasal bone cuts and grafting as needed, and postoperative visits for wound checks and nasal splint removal. Billing uses the revision rhinoplasty code for intermediate procedures with bone work, and appropriate modifiers are applied for surgeon status, multiple procedures, or unusual circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician or other qualified health care professional service |