Summary & Overview
CPT 64776: Excision of Tumor or Mass on Digital Nerve (Finger/Toe)
CPT code 64776 denotes surgical excision of a tumor or mass involving a digital nerve in a finger or toe, performed to alleviate pain and restore nerve function compromised by the lesion or prior trauma. This procedure is an important component of hand and foot surgical care because timely removal of compressive or infiltrative nerve masses can prevent progressive sensory or motor deficits and reduce chronic pain. Nationally, use of this code reflects episodes of care in ambulatory surgical centers, hospital outpatient departments, and occasionally inpatient surgical settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this procedure is used, typical sites of service, and which payers commonly cover or process claims for this service. The publication outlines benchmarking topics and policy considerations relevant to coding, billing, and site-of-service decisions, and highlights areas where coverage language or preauthorization requirements can affect access and reimbursement. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 64776 describes the surgical removal of a tumor or mass from a digital (finger or toe) nerve. The procedure is performed to relieve pain and to restore or improve nerve function lost as a result of the mass or prior trauma.
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Service type: Surgical excision of a nerve mass (tumor/mass removal from a nerve in a finger or toe)
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Typical site of service: Ambulatory surgery center or hospital outpatient surgical suite; may also be performed in an inpatient surgical setting depending on clinical complexity and patient status.
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Clinical & Coding Specifications
Clinical Context
A 45-year-old right-handed patient presents to a hand surgeon with progressive numbness, paresthesia, and focal tenderness in the radial aspect of the middle phalanx of the index finger after a fingertip laceration six months earlier. Physical examination demonstrates a small, palpable, tender, mobile subcutaneous mass along the course of the digital nerve with reproducible radiating pain and decreased two-point discrimination in the affected finger. Conservative care including splinting and a short course of anti-inflammatory medication failed to relieve symptoms. Imaging with ultrasound confirms a well-circumscribed mass consistent with a nerve sheath tumor localized to the digital nerve of the finger.
The clinical workflow includes preoperative evaluation and informed consent, preoperative local or regional anesthesia for a minor outpatient procedure, intraoperative exposure of the affected digital nerve, careful microsurgical excision of the tumor or mass from the nerve fascicle(s) with preservation of nerve continuity when possible, intraoperative neurolysis as needed, wound closure, and short postoperative follow-up for wound check and sensory assessment. Typical site of service is an ambulatory surgery center or hospital outpatient department; procedure is commonly performed by a hand surgeon or orthopedic/plastic surgeon with hand surgery expertise. The service type is minor hand surgery for excision of a nerve tumor in a finger or toe to relieve pain and restore nerve function.
Coding Specifications
| Modifier | Description | When to Use |
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LT |