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2025 CPT code 26553

Transfer of a toe to the hand with microvascular anastomosis; other than great toe, single.

Follow CPT guidelines for surgical procedures on the hand and fingers and microvascular anastomosis.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for a distinct procedural service if additional procedures were performed).

The procedure is medically necessary when a significant portion of a digit is missing due to trauma or congenital defect, and reconstruction is required to restore function.The medical necessity must be justified based on the impact on hand function and the patient's quality of life.

A surgical team, often involving two teams working concurrently, one harvesting the toe and the other preparing the hand for the graft. The procedure requires expertise in microsurgery, orthopedics, and plastic surgery.

IMPORTANT:26550 (Pollicization of a digit), 26551 (Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft), 26554 (Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double)

In simple words: The surgeon moves a toe (not the big toe) from the foot to the hand to replace a missing finger or thumb. Tiny blood vessels and nerves are carefully connected during this complex surgery.

This procedure involves the transfer of a toe (other than the great toe) to the hand to reconstruct a missing thumb or finger.The procedure includes harvesting the toe, preserving its blood vessels, nerves, bone, and tendons, and then transplanting it to the hand using microsurgical techniques to reconnect the vascular and neural structures.The donor site is closed, typically using a skin graft.

Example 1: A patient presents with a congenitally missing thumb. A toe-to-hand transfer is performed to reconstruct a functional thumb using 26553., A patient suffers a traumatic amputation of their index finger.A second toe is transferred to replace the lost finger utilizing 26553., A patient has a severe crush injury to their ring finger resulting in significant loss of tissue. A toe-to-hand transfer (26553) is used to restore length and function.

Preoperative imaging (X-rays, possibly CT scan), detailed surgical notes documenting the specific toe used and the microsurgical techniques employed, postoperative imaging to assess healing and vascular patency, and any complications encountered.

** This code is highly complex and requires specialized surgical skills.Accurate documentation is crucial for appropriate reimbursement.Consideration should be given to any additional procedures that might be performed concurrently.

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