Summary & Overview

CPT 20802: Replantation or Reattachment of Arm

CPT code 20802 denotes surgical replantation or reattachment of a completely amputated arm, a high-acuity, major open procedure performed in hospital operating rooms, typically within trauma and reconstructive surgical services. This code matters nationally because it captures resource-intensive, time-sensitive care with implications for surgical staffing, trauma system readiness, and high-cost perioperative care. Key payers included in the national context are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical scope and typical care setting for this procedure, common payer coverage considerations, and the operational and coding context that affects billing and reimbursement. The publication provides benchmarks where available, summarizes relevant policy considerations for commercial and public payers, and outlines the clinical context for emergency and reconstructive teams involved in limb reattachment. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 20802arm replantationreplantation surgerytrauma surgeryoperative codingsurgical procedureshospital inpatientreattachment

Billing Code Overview

CPT code 20802 describes the surgical replantation or reattachment of a completely amputated arm. This procedure is a major, open, invasive operation performed to reattach an amputated or severed arm with the goal of restoring anatomical continuity and function.

Service type: Major invasive surgical reattachment
Typical site of service: Hospital operating room, often within a trauma or surgical service setting

Clinical & Coding Specifications

Clinical Context

A 35-year-old construction worker presents to the emergency department after a high-energy crush and amputation injury in which his dominant left arm was completely severed at the mid-forearm level. The amputated limb is transported on ice with the patient. Initial evaluation includes airway, breathing, circulation stabilization, tetanus status, and IV antibiotics. Vascular status, contamination, and ischemia time are assessed. The surgical team (orthopedic and/or plastic hand surgeon) evaluates viability for replantation based on injury mechanism, ischemia time, and patient comorbidities. The patient is taken emergently to the operating room for limb replantation under general anesthesia. The operative workflow includes debridement and irrigation, bone fixation (internal fixation or external fixation), repair of arteries and veins with microvascular techniques, tendon and nerve repair, and layered soft tissue closure. Postoperatively, the patient is monitored in an intensive care or specialized microsurgery unit for vascular patency, anticoagulation management, and pain control. Rehabilitation includes early occupational and physical therapy for range of motion, edema control, and functional recovery over weeks to months. This procedure is coded to reflect a major replantation of the arm requiring open operative care and microsurgical reconstruction using 20802.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier

Taxonomy Code	Specialty	Notes
`2080S0004X`	Orthopedic Surgery	Orthopedic trauma surgeons perform bone fixation and musculoskeletal reconstruction for upper-extremity replantation
`2080P0207X`	Plastic and Reconstructive Surgery	Microsurgical arterial and venous repairs, soft tissue reconstruction, and nerve repair are commonly performed by plastic surgeons with hand/microsurgery training
`2084P0800X`	General Surgery (Trauma Surgery)	Trauma surgeons participate in initial control of hemorrhage and stabilization; may assist in limb salvage decisions
`207X00000X`	Hand Surgery (Subspecialty within Orthopedics/Plastics)	Surgeons with dedicated hand surgery credentials commonly perform complex replantation procedures
`362M00000X`	Vascular Surgery	Vascular surgeons may be involved for complex arterial repairs or thrombectomy in limb salvage cases

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S48.012A`	Complete traumatic amputation at forearm level, left arm, initial encounter	Represents a complete amputation of the forearm requiring replantation such as coded by `20802`
`S48.011A`	Complete traumatic amputation at forearm level, right arm, initial encounter	Right-sided equivalent for replantation scenarios when the right arm is involved
`S48.002A`	Complete traumatic amputation at shoulder level, unspecified arm, initial encounter	High-level arm amputations that may be candidates for attempted replantation depending on mechanism and ischemia time
`S48.092A`	Traumatic amputation of other part of upper arm, left arm, initial encounter	Captures atypical or proximal amputation locations requiring complex reconstruction and replantation efforts
`T79.A11A`	Traumatic compartment syndrome of left upper limb, initial encounter	Can complicate crush injuries and influence replantation timing, management, and outcomes

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20690`	Application of plating, tension band, and/or intramedullary fixation devices, open; humerus, radius, ulna (upper arm/forearm)	Used when open internal fixation of forearm or humeral fractures is required as part of replantation bone stabilization
`25295`	Repair, tendon, flexor, forearm and/or wrist, primary or secondary; with graft (includes obtaining graft)	Performed when primary tendon repair or grafting is necessary during replantation for functional restoration
`64831`	Repair of nerve, digital nerve; single branch or trunk, with direct suture	Used for microsurgical nerve repair during replantation to restore sensation and motor function when applicable
`36415`	Collection of venous blood by venipuncture	Common preoperative lab draw for baseline studies (CBC, chemistry) though billed separately by facility/clinic
`36556`	Placement of non-tunneled centrally inserted central venous catheter	May be used perioperatively for resuscitation or medication administration in complex, unstable trauma patients
`66984`	Repair of globe or external eye (placeholder)	Data not available in the input.