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    v1.0.28
    OpenPayerBilling CodesGeneral Introduction or Removal Procedures on the Musculoskeletal SystemCPT cpt-20665-halo-tongs-removal-external-spinal-traction-device
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    CPT 20665: Removal of Halo or Tongs After Spinal Traction

    Medicare pays $122 on average nationally for this procedure.

    CPT code 20665 describes removal of a halo or tongs placed by another provider to provide cranial or cervical traction for correction of spinal deformity; this procedure is a device removal service (orthopedic hardware removal) typically performed as an ambulatory surgical procedure or in an inpatient hospital setting after traction has achieved alignment.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    Clinical & Coding Specifications

    Clinical Context

    A 14-year-old adolescent with progressive high thoracic scoliosis has been managed with skull tongs and halo traction applied by an orthopedic spine team to gradually correct spinal alignment preoperatively. After achieving targeted correction over several days to weeks, the on-call orthopedic provider evaluates the patient in the procedure suite. Under sterile conditions and local anesthesia with sedation as needed, the provider disconnects traction weights, inspects pin sites, loosens and removes tongs or the halo ring, and removes any pin fixation from the skull. Post‑removal care includes hemostasis, wound care instructions, pain control, and documentation of neurovascular status. Typical sites of service are the inpatient ward, inpatient procedure room, or ambulatory surgical/procedure center when removal is scheduled as an outpatient. This service represents the removal of a halo or tongs previously applied by another provider and does not include application, revision of fixation, or definitive spinal surgery.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20660Closed treatment of clavicular fracture; without manipulationMay precede halo removal when traction was used for associated clavicle or shoulder issues (contextual adjunct procedures).
    20664Removal of implant; deep (e.g., buried pins, plates)Related to hardware removal when pins are internal or require deeper dissection beyond halo/tong pins.
    20680Removal of implant; deep (other than joint prosthesis)Used when more extensive removal of fixation devices is required at time of halo/tong removal.
    20670Removal of implant; superficial (e.g., simple pin removal)Commonly used when superficial pins or external fixation are removed in conjunction with halo/tong removal.
    99223Initial hospital care, typically 70 minutesMay be billed for complex inpatient evaluation related to halo/tong removal when time and complexity meet E/M criteria.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    226000000XRecreational Therapist AssistantRecreational Therapist Assistants work in support of or assistant to Recreational Therapists treating patients with disabilities, injuries, and illnes…
    171R00000XInterpreterAn Interpreter is a person who translates oral communication between two or more people. This includes translating from one language to another or in…
    103TM1800XIntellectual & Developmental Disabilities PsychologistBehavioral Health & Social Service Providers · Psychologist
    163WX0800XOrthopedic Registered NurseNursing Service Providers · Registered Nurse
    2355S0801XSpeech-Language AssistantSpeech, Language and Hearing Service Providers · Specialist/Technologist

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    Related Codes

    CPT-20500-SINUS-TRACT-THERAPEUTIC-INJECTION

    CPT 20500: Injection of Therapeutic Agent into Sinus Tract

    CPT-20501-SINUS-TRACT-CONTRAST-INJECTION-DIAGNOSTIC

    CPT 20501: Sinus Tract Contrast Injection for Abscess/Lesion Evaluation

    CPT-20520-FOREIGN-BODY-REMOVAL-MUSCLE-TENDON-SHEATH

    CPT 20520: Removal of Foreign Body From Muscle or Tendon Sheath

    CPT-20525-DEEP-FOREIGN-BODY-REMOVAL-MUSCLE-TENDON-SHEATH

    CPT 20525: Deep Foreign Body Removal from Muscle or Tendon Sheath

    CPT-20526-CARPAL-TUNNEL-INJECTION-SHORT-TERM-RELIEF

    CPT 20526: Injection for Carpal Tunnel Syndrome

    CPT-20527-COLLAGENASE-INJECTION-DUPUYTRENS-CONTRACTURE

    CPT 20527: Collagenase Injection for Dupuytren's Contracture

    CPT-20550-TENDON-OR-LIGAMENT-INJECTION-APONEUROSIS-TREATMENT

    CPT 20550: Injection into Tendon or Ligament for Aponeurosis

    CPT-20551-TENDON-ORIGIN-INSERTION-INJECTION

    CPT 20551: Injection into Tendon Origin or Insertion Site

    CPT-20552-TRIGGER-POINT-INJECTION-ONE-OR-TWO-MUSCLES

    CPT 20552: Trigger Point Injection for Myofascial Pain

    CPT-20553-TRIGGER-POINT-INJECTION-THREE-OR-MORE-MUSCLES

    CPT 20553: Trigger Point Injection, Three or More Muscles

    Showing 1–10 of 41

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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