Summary & Overview
CPT 32551: Chest Tube Placement, Open Cutdown Incision
CPT code 32551 reports an open cutdown incision to place a plastic chest tube for evacuation of air and/or fluid from the pleural space. This surgical thoracic procedure is commonly performed emergently for pneumothorax, for drainage of pleural effusions, and postoperatively for chest drainage, making it a nationally relevant code for inpatient and emergency care settings. Payers of interest in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when CPT code 32551 is used, the typical sites of service where it is performed, and what operational benchmarks and policy considerations are commonly associated with chest tube placement procedures. The publication provides benchmarks (where available), coding and billing context, reimbursement and coverage considerations across major payers, and notes on documentation and procedure reporting practices. Data not available in the input is noted where necessary. The content is intended for payers, hospital coding teams, and clinical leadership seeking a concise, national-level reference for CPT code 32551.
Billing Code Overview
CPT code 32551 describes an open cutdown incision procedure to insert a plastic tube (chest tube) into the chest cavity for removal of fluid and/or air. The service type is a surgical thoracic procedure for pleural drainage. The typical site of service is the hospital operating room, hospital inpatient bedside, or emergency department where chest tube placement is required for management of pneumothorax, pleural effusion, or postoperative chest drainage.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to the emergency department or inpatient unit with acute respiratory distress, pleuritic chest pain, hypoxia, or hemodynamic instability. Imaging (chest X-ray or CT) demonstrates a large pleural effusion or pneumothorax requiring drainage. After informed consent, the patient is positioned and local anesthesia administered. The provider creates an open cutdown incision to expose the chest wall and bluntly dissects to the pleural space. A plastic thoracostomy tube (chest tube) is inserted through the cutdown, secured with sutures, and connected to a drainage system. The procedure is coded as 32551. Typical workflow includes pre-procedure imaging and labs, sterile setup, procedure documentation (indication, technique, size and laterality of tube, type of drainage system), post-procedure chest imaging to confirm placement, monitoring for complications (bleeding, infection, tube malposition), and chest tube management orders (suction level, drainage monitoring) until removal or conversion to a more definitive procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the procedure required substantially greater work than typical due to severe adhesions, difficult anatomy, or extensive hemorrhage. |