CPT code 64821 represents surgical removal or destruction of sympathetic nerves of the radial artery (radial artery sympathectomy) performed to relieve ischemic pain or improve blood flow in patients with narrowed blood vessels. This procedure is a focused peripheral sympathectomy targeting the radial artery and is clinically significant for patients with refractory digital ischemia, severe vasospasm, or other circulatory compromise of the hand. Nationally, accurate coding of this procedure matters for appropriate clinical documentation, claims processing, and evaluation of access to limb- and digit-salvaging interventions.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and site of service, common billing considerations, and the context needed to interpret payer coverage patterns. The publication summarizes applicable benchmarking metrics, potential policy updates affecting coverage and prior authorization, and the clinical scenarios in which CPT code 64821 is typically reported. Data not available in the input is noted where applicable.