2025 CPT code 20972
(Active) Effective Date: N/A Revision Date: N/A Surgery - Bone Grafting Musculoskeletal System Feed
Free osteocutaneous flap with microvascular anastomosis; metatarsal.
Modifiers may be applicable depending on circumstances (e.g., multiple procedures, bilateral procedures). Refer to the CPT manual and payer-specific guidelines.
The medical necessity for this procedure is established by the presence of a significant bone and/or soft tissue defect that cannot be adequately addressed by alternative methods.The osteocutaneous metatarsal flap offers a reconstructive option to restore both bone structure and soft tissue coverage.
The clinical responsibility involves the surgical expertise to perform microsurgery, bone harvesting, tissue transfer, and wound closure.Preoperative planning, assessment of vascular supply, and meticulous surgical technique are crucial for successful outcomes.
In simple words: The surgeon takes a piece of bone, along with its blood vessels and skin, from a toe bone in the foot. This piece of tissue is then moved to another part of the body to repair a bone and skin defect. Tiny blood vessels are connected during surgery to ensure the transplanted tissue survives.
This CPT code encompasses the harvesting of an osteocutaneous flap from a metatarsal bone, which includes bone graft material, its active vascular supply, and an attached layer of cutaneous tissue (skin).The harvested graft is then transferred to a recipient site to fill a bony defect and address soft tissue loss resulting from trauma or disease. The procedure involves meticulous dissection to preserve the vascular supply, debridement of the recipient site, precise placement of the graft, and microvascular anastomosis (joining of arteries and veins) using microsurgical techniques.Closure of both the donor and recipient sites is achieved using layered sutures.
Example 1: A patient suffers a severe foot injury involving significant bone and soft tissue loss.An osteocutaneous flap from a metatarsal bone is harvested and transferred to the injured area using microvascular anastomosis to reconstruct the defect., A patient with a bone tumor requiring resection experiences a significant bone and soft tissue defect after tumor removal. An osteocutaneous metatarsal flap is used to reconstruct the defect, improving both bone integrity and soft tissue coverage., A patient with a congenital deformity requiring bone lengthening has a bone and soft tissue gap after the lengthening procedure. An osteocutaneous metatarsal flap is used to cover the soft tissue defect while the bone is healing.
* Detailed operative report describing the procedure.* Preoperative imaging (e.g., X-rays, CT scans) to assess the defect.* Intraoperative images documenting the harvesting of the flap and the microvascular anastomosis.* Postoperative images to assess healing.* Pathology report if a tumor was involved.
** This code is for a specific type of free flap.Variations in the flap design or recipient site may require additional codes.Always refer to the latest CPT manual and payer guidelines for the most accurate coding.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: The relative value units (RVUs) for CPT code 20972 vary based on geographic location, facility type, and other factors.Consult the appropriate fee schedules for specific reimbursement rates.
- Global Days: The global period for this procedure is not explicitly defined in the provided data.Refer to your payer's specific guidelines or local standards for the appropriate global period.
- Payment Status: Active
- Modifier TC rule: No information provided, but consult CPT guidelines for technical component modifier applicability.
- Fee Schedule: Historical fee schedules are not included in the data.Consult your payer's historical fee data.
- Specialties:Plastic Surgery, Orthopedic Surgery, Microsurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center