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Official Description

Resection of ribs, extrapleural, all stages

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 32900 refers to the resection of ribs performed in an extrapleural manner, which involves the surgical removal of rib sections to facilitate the collapse of one side of the chest. This technique is primarily indicated for patients suffering from conditions such as pulmonary tuberculosis and chronic empyema, where the lung may be compromised and requires intervention to alleviate symptoms or improve function. The extrapleural approach allows for the removal of rib segments while minimizing disturbance to the pleura, which is the membrane surrounding the lungs. Various techniques can be employed during this procedure, ranging from the resection of a small section of rib to a more extensive long posterolateral rib resection. The latter involves a surgical incision over the third rib, followed by careful dissection through the subcutaneous tissue and muscles to access the rib. The procedure is often staged, meaning it may be performed over multiple sessions, particularly in patients who are seriously ill, to ensure better management of their health status and recovery. The use of CPT® Code 32900 encompasses all stages of this rib resection procedure, reflecting its comprehensive nature in addressing the underlying pulmonary issues.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for the following conditions:

  • Pulmonary Tuberculosis - A serious infectious disease that affects the lungs and may require surgical intervention when medical management is insufficient.
  • Chronic Empyema - A condition characterized by the accumulation of pus in the pleural cavity, often necessitating rib resection to facilitate drainage and lung expansion.

2. Procedure

The procedure involves several key steps, which are detailed as follows:

  • Step 1: Incision - The surgeon begins by making an incision over the third rib, carefully cutting through the skin and subcutaneous tissue to access the underlying structures.
  • Step 2: Muscle Dissection - Following the incision, the trapezius and rhomboid muscles are incised to expose the rib. This dissection is crucial for gaining access to the rib for resection.
  • Step 3: Subperiosteal Resection - A subperiosteal resection is performed, which involves removing the rib without disturbing the pleura. This technique minimizes complications and preserves the integrity of the pleural space.
  • Step 4: Rib Removal - A long section of the third rib is removed to achieve the desired collapse of the chest wall and compression of the lung. In some cases, a smaller portion of the fourth rib and possibly additional ribs may also be resected using the same extrapleural subperiosteal technique.
  • Step 5: Staging of the Procedure - Given that patients undergoing this procedure are often seriously ill, the rib resection may be performed in stages over several operative sessions to ensure optimal management of their health and recovery.

3. Post-Procedure

Post-procedure care typically involves monitoring the patient for complications, managing pain, and ensuring proper respiratory function. Patients may require additional interventions or supportive care, especially if the procedure was staged. Recovery time can vary based on the extent of the resection and the overall health of the patient, with careful follow-up necessary to assess lung function and manage any ongoing symptoms related to the underlying conditions.

Short Descr REMOVAL OF RIB(S)
Medium Descr RESECTION RIBS EXTRAPLEURAL ALL STAGES
Long Descr Resection of ribs, extrapleural, all stages
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 142 - Partial excision bone
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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