2025 CPT code 20973
(Active) Effective Date: N/A Revision Date: N/A Surgery - Other Procedures on the Musculoskeletal System Musculoskeletal System Feed
Free osteocutaneous flap with microvascular anastomosis; great toe with web space.
Modifiers may apply depending on the circumstances of the procedure (e.g., modifier 50 for bilateral procedures, modifier 76 for repeat procedures). Consult the CPT manual for complete information on modifier usage.
The medical necessity of this procedure is established when there is a significant bone defect or soft tissue loss that cannot be adequately managed with other techniques. The procedure is considered medically necessary to restore function, structural integrity, and improve quality of life.
The clinical responsibility involves the surgeon's expertise in microsurgery, bone grafting techniques, and reconstructive surgery.Preoperative planning includes imaging studies to assess the defect and design the graft. Intraoperatively, meticulous dissection and microsurgical anastomosis are critical. Postoperative care includes monitoring for complications like flap failure or infection.
In simple words: The surgeon removes a piece of bone, skin, and blood vessels from the great toe.This is then attached to another part of the body to repair a bone or skin defect.
This CPT code describes the surgical procedure involving harvesting a free osteocutaneous flap from the great toe, including its vascular supply and overlying skin, and then performing a microvascular anastomosis to attach it to a recipient site.This is typically done to reconstruct bony defects and associated soft tissue loss due to trauma or disease. The procedure includes meticulous dissection of the bone graft with its intact vascular pedicle, preparation of the recipient site (including debridement of necrotic tissue), precise placement of the graft, and microsurgical anastomosis of the vessels. Closure of both donor and recipient sites with layered sutures is also included.
Example 1: A patient sustains a traumatic injury resulting in a significant bone defect in the lower leg.The surgeon uses a free osteocutaneous great toe flap to reconstruct the defect and restore soft tissue coverage., A patient has a large bone defect in the mandible due to a tumor resection. The surgeon utilizes a free osteocutaneous great toe flap to fill the defect and provide structural support for the jaw., A patient experiences significant bone loss in the hand due to infection.The surgeon uses a free osteocutaneous great toe flap to fill the defect and restore hand function.
** Do not report code 69990 (Microsurgical techniques) in addition to code 20973.For great toe wrap-around procedures, use code 26551 instead.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: The RVUs for this code will vary depending on the geographic location and the specific payer. Consult your payer's fee schedule for accurate information.
- Global Days: The global period for this procedure is typically 90 days post-op. This means that any related services within this timeframe would be bundled into the primary procedure charge unless explicitly allowed by guidelines or the payer.
- Payment Status: Active
- Modifier TC rule: No specific TC modifier is directly applicable, however,refer to your specific payer's guidelines.
- Fee Schedule: Historical fee schedule data is not available in the provided source, but you can access the data from your payer or the AMA.
- Specialties:Plastic Surgery, Orthopedic Surgery, Microsurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center