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Is freeing enough to overcome unbundling? 34713 Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus with 21615 Excision first and/or cervical rib. A supraclavicular incision Platysma divided. Anterior scalene fat pad mobilized laterally & superiorly. Omohyoid divided. Phrenic nerve carefully preserved & a 2-3 cm segment of anterior scalene was resected. The brachial plexus was scarred and this was freed of its investing scar tissue. Bony structure that was most likely the cervical rib was identified. Was circumferentially cleared & divided with rongeur cephalad. PT had only the tendinous attachment and this was cut with sutures. This was removed & sent to pathology. The first rib was more lateral and larger than normal. This was freed circumferentially as well. An infraclavicular incision was carried out and the first rib was also circumferentially cleared at this location. Rongeur was used to divide the rib both posteriorly & superiorly & ultimately an 11 cm segment of rib was removed. The pleura appeared intact. Hemostasis ensured.