2025 CPT code 64721
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Neuroplasty and/or transposition of the median nerve at the carpal tunnel.
Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 51 (multiple procedures) may be used if additional procedures are performed during the same surgical session.Consult the CPT manual and payer-specific guidelines for appropriate modifier usage.
Medical necessity for 64721 is established by the presence of clinically significant symptoms and diagnostic findings consistent with carpal tunnel syndrome or other conditions causing median nerve compression at the carpal tunnel.Conservative treatment should have failed or been deemed unsuitable before surgical intervention is considered. Documentation should support the need for surgery.
The clinical responsibility for this procedure rests with a surgeon specializing in hand surgery or peripheral nerve surgery. The surgeon's duties include preoperative assessment and planning, performing the surgical procedure, ensuring hemostasis, meticulous wound closure, and postoperative care, including patient education and follow-up.
In simple words: This code describes a surgery to release pressure on a nerve in your wrist (median nerve) that's causing carpal tunnel syndrome. The surgeon makes an incision to remove scar tissue or anything pressing on the nerve and may reposition the nerve to improve its function.
This CPT code 64721 represents the surgical procedure involving neuroplasty and/or transposition of the median nerve located at the carpal tunnel.The procedure aims to decompress or free the median nerve from any restrictive scar tissue or other constricting elements within the carpal tunnel.This may involve techniques such as external neurolysis or transposition of the nerve to restore its normal function. The procedure is often performed to alleviate symptoms associated with carpal tunnel syndrome (CTS), such as numbness, tingling, and weakness in the hand and fingers.This specific code excludes procedures that require the use of an operating microscope or endoscopic techniques.
Example 1: A 45-year-old female patient presents with classic symptoms of carpal tunnel syndrome in her right hand, including numbness, tingling, and weakness.A nerve conduction study confirms the diagnosis.Open carpal tunnel release (64721) is performed to decompress the median nerve., A 60-year-old male patient has undergone previous carpal tunnel surgery, but his symptoms have recurred.During the revision surgery, the surgeon performs a neuroplasty and transposition of the median nerve at the carpal tunnel (64721) to address scar tissue formation and persistent nerve compression., A 30-year-old patient sustains a laceration to their wrist, resulting in damage to the median nerve.Surgical repair includes a neuroplasty and nerve grafting (64721) to restore nerve function. The surgeon may use additional codes to reflect the nerve grafting portion of the procedure.
Preoperative evaluation with documentation of symptoms, physical exam findings, and diagnostic studies (e.g., nerve conduction studies, electromyography).Operative report detailing the surgical technique, including the extent of neurolysis or transposition performed, and any complications encountered.Postoperative progress notes documenting the patient's recovery, any complications, and follow-up care.Imaging studies (if applicable).
** Always ensure accurate documentation to support the medical necessity and appropriate coding of this procedure.Be aware of the potential for unbundling and coding compliance issues. Refer to payer-specific guidelines for any local coverage determinations or other specific requirements.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: This information is not available in provided sources.Refer to CMS guidelines and local payer policies for RVU information.
- Global Days: This information is not available in provided sources. The global period will depend on the specific payer and their policies.
- Payment Status: Active
- Modifier TC rule: This information is not available in provided sources.Whether a technical component (TC) modifier applies depends on the specific circumstances and payer.
- Fee Schedule: Fee schedule information is not provided.Historical fee data can vary significantly depending on location, payer, and time period. Consult fee schedules specific to the location and payer involved.
- Specialties:Hand Surgery, Orthopedic Surgery, Neurosurgery, Plastic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)