CPT 32810 Chest Wall Closure Reimbursement | OpenPayer

Summary & Overview

CPT 32810: Chest Wall Closure After Continuous Drainage and Irrigation for Empyema

CPT code 32810 denotes surgical closure of the chest wall after continuous drainage and irrigation for empyema, a condition in which pus accumulates within the pleural space. This procedure is clinically significant nationwide due to the morbidity of empyema and the resource intensity of thoracic surgical care, including the need for inpatient operating-room resources and postoperative management. Payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.

Readers will find a concise briefing on the clinical context of CPT code 32810, the typical sites of service, and the service type. The publication summarizes payer coverage considerations and common modifier usage where available, and it highlights benchmarking metrics and relevant policy updates impacting coding and reimbursement for thoracic surgical procedures. The content provides guidance on documentation focus areas that support accurate coding and claims submission for chest wall closure after empyema drainage, and it outlines common ancillary services typically billed alongside the primary procedure. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareCPT 32810thoracic surgeryempyemachest wall closuresurgical codinginpatient surgeryoperating room procedures

Billing Code Overview

CPT code 32810 describes closure of the chest wall following continuous drainage and irrigation of empyema, a surgical procedure to close the thoracic wound after evacuation and sterilization of purulent fluid from the pleural space. The procedure typically follows interventions to manage empyema and aims to restore chest wall integrity and prevent recurrent infection.

Service Type

Surgical — Thoracic/Chest Wall Closure

Typical Site of Service

Inpatient hospital or operating room, often performed where chest drainage and irrigation for empyema have been managed under surgical or thoracic care.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult admitted with a parapneumonic empyema or complicated pleural space infection requiring surgical drainage and prolonged irrigation. The patient presents with fever, pleuritic chest pain, leukocytosis, and imaging (chest x-ray and CT) demonstrating loculated pleural fluid with air-fluid levels. Initial management includes intravenous antibiotics and chest tube drainage; when drainage is inadequate or there is a persistent infected pleural cavity, the thoracic surgeon performs operative open or video-assisted debridement with continuous drainage and irrigation of the empyema followed by definitive chest wall closure. The clinical workflow includes preoperative optimization (antibiotics, chest tube management, coagulation assessment), operative irrigation and placement of drain systems, completion of continuous irrigation until infection control is achieved, and formal closure of the chest wall under general anesthesia. Postoperative care includes wound monitoring, continued antibiotics, chest tube/drain management, pulmonary hygiene, and follow-up imaging to confirm resolution of the empyema.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no specific modifier applies; many payors do not recognize `00` as billable — include only if required by payer.

CPT 32820: Surgical Stabilization of Chest Wall After Trauma

CPT-32815-BRONCHIAL-FISTULA-CLOSURE-SURGICAL-REPAIR

CPT 32815: Surgical Closure of Bronchial Fistula

CPT-32800-LUNG-REPAIR-PULMONARY-HERNIATION

CPT 32800: Surgical Repair of Pulmonary Herniation

Taxonomy Code	Specialty	Notes
2084P0800X	Thoracic Surgery	Thoracic surgeons commonly perform empyema debridement, irrigation, and chest wall closure.
2080P0201X	General Surgery	General surgeons with thoracic experience may perform pleural space procedures in some settings.
207K00000X	Pulmonary Critical Care Medicine	Pulmonologists often manage initial chest tube drainage and coordinate surgical referral; they do not typically perform open chest wall closure but are part of care team.
208600000X	Cardiothoracic Surgery	Cardiothoracic surgeons overlap with thoracic surgery for complex pleural space infections.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J86.0`	Pyothorax with fistula	Represents pleural space infection (empyema) that may require surgical drainage and chest wall closure.
`J86.9`	Pyothorax without fistula, unspecified	Common empyema diagnosis indicating pus in pleural cavity requiring drainage and possible operative closure.
`J15.9`	Pneumonia due to unspecified bacteria	Underlying pneumonia can lead to parapneumonic effusion and secondary empyema necessitating this procedure.
`J90`	Pleural effusion, not elsewhere classified	Pleural fluid accumulation that, if infected or loculated, may progress to empyema treated with drainage and closure.
`J91.0`	Pleural effusion in conditions classified elsewhere, malignant	Malignant effusions can become complicated; though less common, surgical drainage/closure may be required in selected cases.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32550`	Tube thoracostomy, includes water-seal drainage; simple (eg, for pleural effusion), without suction	Often performed prior to definitive operative drainage; initial chest tube placement for empyema management.
`32601`	Decortication, pulmonary; with thoracotomy (eg, stripping of visceral pleura)	Performed when restrictive rind prevents lung re-expansion; may be done before or with continuous irrigation and closure.
`32666`	Thoracoscopic decortication (video-assisted), including pleural drainage	Minimally invasive alternative for debridement and drainage prior to or instead of open chest wall closure.
`32557`	Thoracentesis, needle aspiration, not including indwelling catheter (diagnostic or therapeutic)	May be used for diagnostic sampling or temporary therapeutic drainage before surgical intervention.
`31628`	Thoracotomy, with exploration, with closure of bronchopleural fistula, diaphragmatic repair or other complex pleural procedures (note: code choice depends on specific procedures)	Used when additional intrathoracic repairs are required during the same operative episode; may accompany closure after empyema irrigation.

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