Summary & Overview
CPT 20662: Halo Pelvic Fixation for Spinal Traction and Immobilization
CPT code 20662 denotes halo pelvic fixation, a surgical traction and immobilization procedure used to correct spinal curvature or dislocation and to stabilize the spine. It covers placement of a pelvic hoop with pins, a skull halo, and vertical connecting bars, and includes removal of the pelvic halo. This code is relevant nationally for spine surgery programs, trauma centers, and orthopedics and neurosurgery practices that manage severe deformity, lumbosacral spondylolisthesis, scoliosis, and tuberculous kyphosis.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and what to expect in billing and claims workflows for this specialized fixation procedure. The publication highlights national benchmarks where available, recent policy or coding updates affecting utilization and coverage, and clinical considerations that commonly accompany claims for complex spinal traction and immobilization. Data not available in the input where relevant will be noted.
Billing Code Overview
CPT code 20662 describes halo pelvic fixation, a procedure that applies traction force for correction of spinal curvature or dislocation and for immobilization of the spine. The pelvic halo construct includes a pelvic hoop with two pins, a skull halo, and four vertical threaded bars connecting the pelvic hoop and skull halo. The service explicitly includes removal of the pelvic halo as part of the procedure.
-
Service type: Surgical fixation/traction procedure for spinal correction and immobilization
-
Typical site of service: Inpatient or outpatient operating room or procedure suite where spinal fixation/traction devices are applied and removed
Clinical & Coding Specifications
Clinical Context
A 16-year-old adolescent with progressive idiopathic scoliosis presents with a 70-degree thoracolumbar curvature and significant trunk imbalance after failed conservative management (brace and observation). The orthopedic spine surgery team elects to place a halo pelvic fixation to apply gradual traction and correct spinal deformity prior to definitive posterior spinal fusion. The typical workflow includes preoperative assessment (imaging, neurologic baseline exam), placement of a skull halo and pelvic hoop with two pelvic pins under general anesthesia in the operating room, connection with four vertical threaded rods, staged traction adjustments while inpatient, regular neurovascular and pin-site checks, imaging to monitor correction, and eventual removal of the pelvic halo once adequate alignment or immobilization has been achieved. The documented service includes placement and application of traction and removal of the pelvic halo when performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for halo pelvic fixation (document rationale). |
23 | Unusual anesthesia |