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ACGME Facial Plastic / Trauma Codes

Closed reduction of nasal fracture: 21315 (“without stabilization”), 21320 (if you placed a cast, finger cot or surgicel)
*Open reduction of nasal fracture: (log this as closed rhinoplasty with bony work: 30435)
*ZMC/midface fracture: 21360
(if done with ophtho, log orbital fx as assist as well (21390) and log canthotomy 67715 if used)
*Gilles approach for zygomatic arch repair 21356
*Mandible fracture:
-Log each aspect of case separately (maximally unbundle, you’re surgeon if you did half of each of these aspects):
 MMF: 21453
 ORIF mandible fx: 21462


*Open rhinoplasty:
 Septoplasty: 30520
 *Rhinoplasty: 30410
 *Revision rhinoplasty: 30450
 Nasal valve repair: 30465
 Septal cartilage graft: 20912
Calvarial bone graft: 21210
Rhytidectomy 15828
Platysmectomy (platysmal tightening) 15825
Facial plastics botox injection (not larynx) 96372
Blepharoplasty: (Log each eye and each site (upper or lower) separately)
 Upper blepharoplasty: 15822
 Lower blepharoplasty: 15821
Repair ectropion: 67916
Brow lift any type, eg direct (Deschler): 67900
Eyelid weight 67912
Removal of eyelid weight 67912
Tarsal strip 67917


Gracilis free flap: Log as two cases each with two entries:
     Myogenous free flap for paralyzed face:
        15842 (assist)
    Neurorrhaphy (assist or surgeon if you place ½ the sutures) 64886
     Fascia lata graft 20922
     Closure of leg wound: 12036 (surg)
     Close the face: 12055 (surg)
STSG to face (eyelids,nose,mouth, lips,ears) or neck: 15120
Dermal graft (i.e. dermis alone) to face or neck: 15135

Moh’s reconstruction (tissue rearrangement, advancement, rotational flaps):
     *eyelids, nose, ear, lips <10cm2: 14060
if 10-30cm2: 14061
     *forehead, cheek, chin, mouth, lips <10cm2: 14040,  if 10-30cm2: 14041
      *takedown of melolabial flap pedicle 15630

Microtia repair
 1st stage with rib graft 21230
 *2nd stage lobule transposition 14061
 3rd stage elevation of auricle with STSG     
                       *14061 and 15120 for skin graft