Summary & Overview

CPT 20822: Replantation of Finger (Excluding Thumb)

CPT code 20822 captures the replantation of a completely amputated finger (excluding the thumb), a high-acuity surgical procedure requiring microsurgical skills and inpatient operating room resources. Nationally, this code represents critical reconstructive care that impacts functional outcomes, limb salvage rates, and acute surgical resource utilization. It is relevant for hospital surgical departments, specialty practices in hand and microsurgery, and payers managing high-cost, high-complexity episodic care.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, expected site-of-service and service type, and the focus areas for payer policy and coverage: authorization requirements, inpatient versus outpatient settings, and claim documentation tied to operative complexity. The publication also highlights typical benchmarking considerations for cost and utilization for major replantation procedures, and summarizes common coding and billing themes that affect reimbursement and claims processing.

This resource is written for national stakeholders interested in procedural classification, billing consistency, and policy implications for major reconstructive digit reattachment services. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare20822CPTdigit replantationhand surgerymicrosurgeryreconstructive surgeryinpatient surgeryoperative procedure

Billing Code Overview

CPT code 20822 describes the replantation of a digit (finger), excluding the thumb, after complete amputation. This procedure is a major, open invasive surgical operation that involves microsurgical and reconstructive techniques to reattach the amputated digit to restore form and function.

Service type: Major reconstructive/microsurgical replantation procedure
Typical site of service: Hospital operating room, often performed by orthopedic or plastic surgery teams with microsurgery capability

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 32-year-old male construction worker presents to the emergency department after a circular saw injury resulting in a complete amputation of the ring finger distal to the proximal interphalangeal joint. After initial hemostasis, analgesia, tetanus prophylaxis, and imaging to confirm level of amputation, the amputated digit is wrapped, cooled, and transported with the patient. The hand surgery team evaluates vascular viability and contamination risk and discusses replantation feasibility with the patient. In the operating room under general anesthesia, microsurgical revascularization, tendon and nerve repair, and skeletal fixation are performed to reattach the finger. Postoperative care includes admission to a monitored bed for vascular checks, anticoagulation per institutional protocol, wound care, occupational therapy planning, and outpatient follow-up for monitoring viability, rehabilitation, and potential secondary procedures (e.g., tenolysis or revision skin coverage). Typical workflow steps: emergency triage and stabilization, imaging and consent, transfer to operating room, replantation surgery (20822), immediate postoperative monitoring in PACU/ICU-level observation as indicated, hand therapy referral, and staged outpatient reconstruction if needed.

Coding Specifications

Modifier	Description	When to Use
`62`	Two surgeons	When two surgeons work together performing distinct portions of the replantation requiring documentation of shared active roles.

Taxonomy Code	Specialty	Notes
207XS0102X	Plastic Surgery	Microsurgical reconstruction and digit replantation expertise; commonly performs `20822`.
2080P0222X	Hand Surgery (Orthopedic)	Orthopedic hand surgeons perform complex replantation and skeletal fixation.
208000000X	General Surgery	In some trauma centers, general surgeons with microsurgical training may participate.
261QM0800X	Occupational Therapy	Postoperative rehabilitation and hand therapy (evaluations and therapy services).

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`26055`	Repair, tendon sheath and/or tendon, hand or finger, primary, without free graft; flexor or extensor — simple	May be performed concurrently or during replantation for tendon repairs of the digit.
`25210`	Amputation, finger, through the proximal phalanx; single	May be performed if replantation is not possible or in staged revision/amputation scenarios.
`69990`	Microsurgical techniques, requiring an operating microscope (List separately in addition to code for primary procedure)	Billed in addition to `20822` when operative microscope is used for microvascular anastomosis.
`20680`	Removal of deep implant; exploration of neurovascular bundle, if required	May be used in secondary procedures for hardware removal or exploration of compromised vascular repair.
`99024`	Postoperative follow-up visit, postoperative global period — follow-up typically in facility billing contexts	Used to report significant postoperative follow-up visits during the global period when separately billable per payer rules.

OpenPayer