Summary & Overview
CPT 64726: Plantar Digital Nerve Decompression
CPT code 64726 represents surgical decompression of the plantar digital nerve located between toes to relieve compression from surrounding ligaments. This targeted peripheral nerve procedure addresses interdigital neuropathic pain and can reduce symptoms such as burning, tingling, and numbness. Nationally, the code is relevant to ambulatory surgical and outpatient settings where podiatric and peripheral nerve surgeons manage localized nerve entrapment.
Key payers considered in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical framing of the procedure, common sites of service, and the coverage context for major commercial payers and the Medicare program. The publication summarizes benchmark utilization patterns, coding and billing considerations, and policy developments affecting surgical peripheral nerve procedures.
This report provides: an explanation of what CPT code 64726 covers clinically; an overview of where and how the service is commonly delivered; a summary of payer coverage themes and prior authorization trends for similar procedures; and guidance on common billing considerations and related códigos for clinical documentation. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 64726 describes decompression of the plantar digital nerve situated between two toes. The procedure involves freeing the nerve from surrounding ligaments and soft tissues that are exerting pressure, with the clinical aim of relieving neuropathic pain or paresthesia in the affected interdigital space.
Service type: Surgical — peripheral nerve decompression
Typical site of service: Ambulatory surgery center or hospital outpatient department, and in some cases an office-based procedure room for minor procedures under local anesthesia when facility resources permit.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to a podiatry clinic with progressive burning pain and numbness localized to the web space between the third and fourth toes, worse with ambulation and tight footwear. Exam demonstrates focal tenderness along the plantar digital nerve distribution and positive Mulder-like squeeze reproducing paresthesia, consistent with interdigital (Morton) neuroma compressing the plantar digital nerve. Conservative management including footwear modification, corticosteroid injection, activity modification, and orthotics has been attempted for 3–6 months with insufficient symptom relief. The provider schedules a surgical decompression of the plantar digital nerve (CPT 64726) performed under regional or local anesthesia in an ambulatory surgery center or hospital outpatient setting. The procedure involves a small dorsal or plantar incision, identification of the affected plantar digital nerve that passes between the toes, meticulous release of constricting ligaments and fibrous tissue, and confirmation of decompression. Postoperative workflow includes short recovery, analgesia, wound care instructions, weight-bearing guidance, and outpatient follow-up for wound check and functional recovery assessment. Typical documentation includes operative report with laterality, incision site, specific nerve decompressed, anesthesia type, estimated blood loss, complications (if any), and postoperative instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |