Summary & Overview
CPT 64831: Repair of Nerve in Finger or Toe
CPT code 64831 denotes surgical repair of a peripheral digital nerve in a finger or toe to restore sensory and/or motor function after traumatic injury. This code captures a focused microsurgical procedure commonly performed by hand and peripheral nerve surgeons and is critical to functional recovery, patient quality of life, and downstream rehabilitation needs. Nationally, timely repair influences outcomes and utilization of follow-up services including therapy and potential secondary procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the code, the typical care setting, and what to expect in coverage and billing workflows. The publication summarizes available benchmarks and common modifier usage patterns where documented, highlights payer differences in prior authorization and medical necessity expectations when present, and outlines implications for surgical and post‑operative billing lines.
The report is intended for billing managers, surgical providers, and policy analysts seeking a national overview of CPT code 64831 — covering clinical purpose, service setting, payer considerations, and items to review in claims and appeals. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 64831 describes surgical repair of a nerve in a finger or toe. The procedure is performed to restore sensory and/or motor function after nerve injury or severance caused by trauma.
Service Type: Surgical — peripheral nerve repair (hand/foot)
Typical Site of Service: Ambulatory surgical center or hospital operating room, with occasional performance in an outpatient surgical procedure suite depending on facility resources and case complexity.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand dominant construction worker presents to the emergency department after a laceration to the volar aspect of the ring finger from broken glass. Exam demonstrates an open wound with loss of two-point discrimination distal to the laceration and diminished flexor tendon function. Neurovascular exam shows intact digital arterial flow but a severed digital nerve. After initial wound care and imaging to rule out fracture, the patient is taken to the operating room for exploration and microsurgical repair. The procedure 64831 (repair of a nerve in a finger or toe) is performed under regional or general anesthesia with operative magnification; the surgeon identifies the proximal and distal nerve ends, performs debridement of nonviable tissue, and completes an end-to-end epineurial repair with microsutures. Postoperative workflow includes immobilization, pain control, wound care, and a hand therapy plan to monitor sensory recovery and prevent stiffness. Follow-up visits occur at 1–2 weeks for wound check and suture removal, and serial assessments of sensory and motor return over months.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds the typical for 64831. Documentation must support additional work. |