2025 CPT code 26554
(Active) Effective Date: N/A Revision Date: N/A Surgery - Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers Musculoskeletal System Feed
Transfer of two toes (other than the great toe) to the hand with microvascular anastomosis.
Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 50 (bilateral procedure) if two hands are operated on simultaneously and modifier 76 (repeat procedure) if the procedure is repeated.
Medical necessity for 26554 is established when the patient has significant functional impairment of the hand due to congenital anomalies, trauma, or other conditions that warrant reconstructive surgery.The procedure should improve hand function and quality of life.
The clinical responsibility includes pre-operative planning, surgical execution (often requiring two surgical teams working concurrently), post-operative care, and monitoring of the grafts.The surgeon must have expertise in microsurgery and hand reconstruction.
- Musculoskeletal System
- Surgical Procedures on the Hand and Fingers > Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers
In simple words: This surgery uses toes (not the big toe) from the foot to replace missing fingers or thumb on the hand.Tiny blood vessels, nerves, and tendons are carefully connected to restore function.
This procedure involves the transfer of two toes (excluding the great toe) from the foot to the hand to reconstruct missing digits.The toes are harvested with their associated blood vessels, nerves, bones, and tendons. Microsurgical techniques are used to reattach the toes to the hand, restoring blood supply, nerve function, and tendon continuity.The donor sites on the foot are closed, often using skin grafts.
Example 1: A patient with a congenital absence of the thumb undergoes a double toe-to-hand transfer using 26554 to reconstruct a thumb and index finger., A patient sustains a severe hand injury resulting in the loss of two digits.26554 is used to transfer two toes to restore function and appearance., A child born with symbrachydactyly (a condition where the hand and fingers are underdeveloped) undergoes a bilateral toe-to-hand transfer, using 26554 for each hand.
Detailed pre-operative assessment including the patient's medical history, physical examination, and imaging studies (X-rays, CT scans). Intraoperative documentation, including details of the harvested toes, recipient sites on the hand, and microvascular anastomosis. Post-operative care, including monitoring of grafts, wound healing, and physical therapy.
** This procedure is highly complex and requires specialized surgical expertise in microsurgery and hand reconstruction.The success of the procedure depends on meticulous surgical technique and appropriate post-operative care.The length of stay will depend on the patient's condition and the complexity of the procedure.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information requires access to specific payer fee schedules and may vary by location and contract.
- Global Days: The global period for this procedure will vary based on payer and specific circumstances. Consult payer guidelines for details.
- Payment Status: Active
- Modifier TC rule: No TC modifier is typically used for this code, as it encompasses the entire surgical procedure.
- Fee Schedule: Fee schedule data varies significantly based on location, payer, and year.Consult relevant fee schedules for specific historical information.
- Specialties:Plastic Surgery, Hand Surgery, Microsurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center