CPT® Code 21230

The procedure described by CPT® Code 21230 involves the harvesting of autogenous rib cartilage for use in reconstructive surgery on the face, chin, nose, or ear. This type of graft utilizes the patient's own rib cartilage, typically sourced from the eighth or ninth rib, although the tenth rib may also be utilized if additional cartilage is necessary. The process begins with a surgical incision made over the targeted rib, followed by careful dissection to access the rib perichondrium. It is crucial to perform this dissection with precision, as the pleura, which is the membrane surrounding the lungs, can be closely adhered to the perichondrium. Once the rib cartilage is freed from the surrounding soft tissue, it is excised to create the graft. After harvesting the cartilage, the surgical site is inspected for any potential pleural leaks by instilling saline into the wound, which helps identify air bubbles that may indicate a tear in the pleura. If a tear is detected, it is repaired with sutures before the soft tissues are closed in layers. The harvested cartilage graft is then shaped and sized appropriately to reconstruct the specific deformity of the face, chin, nose, or ear, ensuring that the graft integrates well with the surrounding anatomical structures.