Orthopedic CPT codes

Percutaneous arthrodesis of the sacroiliac joint performed under image guidance, with placement of intra-articular implant(s) — such as bone allograft or a synthetic device — without transfixing the joint.

Percutaneous vertebral augmentation of one lumbar vertebral body using a mechanical device (e.g., kyphoplasty), including cavity creation, unilateral or bilateral cannulation, and all imaging guidance. Fracture reduction and bone biopsy are included when performed.

Percutaneous vertebral augmentation of a single thoracic vertebral body, including cavity creation via mechanical device (e.g., balloon kyphoplasty), with imaging guidance included.

Percutaneous cryoablation of one or more bone tumors, including destruction of adjacent soft tissue involved by tumor extension, with imaging guidance bundled into the code when performed.

Bone graft to the mandible, including harvest of the graft from a donor site by the operating surgeon.

Augmentation of the mandible using a bone graft, typically to build up deficient jaw volume for reconstructive purposes.

Percutaneous ablation of one or more bone tumors using radiofrequency energy, including treatment of adjacent soft tissue involved by tumor extension, with imaging guidance when performed.

Surgical reattachment of a completely amputated hand, including all structures from the hand through the metacarpophalangeal joints.

Microvascular transfer of two toes (neither the great toe) to reconstruct two absent or amputated digits on the hand.

Free toe joint transfer to the hand using microvascular anastomosis, replacing a finger joint destroyed by trauma or congenital deformity.

Add-on code for percutaneous vertebral augmentation of each additional thoracic or lumbar vertebral body beyond the first, including cavity creation with a mechanical device, imaging guidance, fracture reduction, and bone biopsy when performed. Always listed in addition to 22513 or 22514.

Great-toe wrap-around transfer to the hand with microvascular anastomosis and bone graft for thumb reconstruction

Toe-to-hand transfer with microvascular anastomosis, single digit other than the great toe

Complete replantation of a traumatically amputated forearm, reattaching bone, vessels, nerves, and soft tissue.

Free osteocutaneous flap harvested from the great toe with web space, transferred to a recipient site using microvascular anastomosis to restore both bone and soft tissue.

Surgical augmentation of the mandibular body or angle using prosthetic implant material to enlarge or reshape the lower jaw.

Free osteocutaneous flap harvested from the iliac crest, including bone, overlying skin, and intact vascular pedicle, transferred with microvascular anastomosis to reconstruct a distant defect.

Free osteocutaneous flap transfer from a metatarsal donor site, with microvascular anastomosis, to reconstruct a recipient site requiring both bone and skin coverage.

Surgical reattachment of a completely amputated foot, restoring bony, vascular, tendinous, and neural continuity.

Radical resection of a tumor or infection involving the total innominate bone (ilium, ischium, and pubis as a composite structure), with wide excision margins extending into surrounding healthy tissue.

Microvascular bone graft harvested from the metatarsal, transferred to a recipient site with microsurgical vascular anastomosis to restore active blood supply.

Surgical reattachment of a completely severed arm, spanning from the surgical neck of the humerus through the elbow joint.

Microvascular bone graft harvested from a donor site other than the fibula, iliac crest, or metatarsal, transplanted with its intact arterial and venous supply to fill a major skeletal defect at the recipient site.

Reconstruction of the midface (Le Fort III level) with advancement using an internal distraction device — a high-complexity craniofacial procedure performed for severe midface hypoplasia or retrusion.

Bone graft harvested from the iliac crest and transferred to a recipient site using microvascular anastomosis to restore the graft's blood supply.

Free osteocutaneous flap transfer with microvascular anastomosis, harvested from a donor site other than the iliac crest, metatarsal, or great toe, to reconstruct combined bone and soft tissue defects.

Three-column thoracic spine osteotomy via posterior or posterolateral approach, resecting one vertebral segment including pedicles and posterior vertebral wall — the pedicle subtraction osteotomy (PSO) at the thoracic level.

Harvest and transfer of a vascularized fibula bone graft using microvascular technique, including anastomosis of the accompanying blood supply to the recipient site.

Revision or replacement of a previously implanted cervical total disc arthroplasty, performed via an anterior approach at a single interspace.

Radical resection of a pelvic or hip tumor involving the ilium with acetabulum, both pubic rami, or the ischium with acetabulum — removing the tumor plus a margin of surrounding healthy bone and tissue.

Posterior spinal arthrodesis for deformity correction spanning 13 or more vertebral segments, performed with or without application of a body cast.

Three-column lumbar spinal osteotomy performed via a posterior or posterolateral approach on a single vertebral segment, involving removal of a wedge of bone to correct fixed sagittal or coronal deformity in the lumbar spine.

Reconstruction of the midface using a Le Fort III advancement combined with a distraction osteogenesis device, performed without simultaneous intracranial surgery.

Kyphectomy with circumferential spinal exposure and full resection of three or more vertebral segments, including vertebral body and posterior elements.

Impression-taking and custom fabrication of an orbital prosthesis to restore the eye socket following enucleation or exenteration.

Periorbital osteotomies for orbital hypertelorism using a combined intra- and extracranial approach, with bone grafts to reposition the orbits and fill bony defects.

Partial or complete lumbar vertebral body resection via lateral extracavitary approach, single segment, with spinal cord and/or nerve root decompression.

Reconstruction of the orbital walls, rims, forehead, and nasoethmoid complex after intra- and extracranial excision of a benign cranial bone tumor, using multiple autografts with a total bone-graft area exceeding 80 square centimeters — graft harvesting is included.

Reconstruction of the superior-lateral orbital rim and lower forehead, with advancement or repositioning, including autograft harvest when performed.

Open surgical repair of a mandibular fracture using interdental fixation — wiring or splinting the teeth together to stabilize the lower jaw while it heals.

Removal of a previously implanted single-level cervical total disc arthroplasty device at one interspace.

Periorbital osteotomies for orbital hypertelorism with forehead advancement and bone grafts, using a combined intra- and extracranial approach.

Arthrodesis at the lumbosacral junction (L5-S1) performed via a presacral, retroperitoneal interbody approach with implant placement.

Reconstruction of orbital walls, rims, forehead, and nasoethmoid complex after intra- and extracranial excision of a benign cranial bone tumor, using multiple autografts, where the total bone graft area falls between 40 and 80 square centimeters.

Electrocorticography performed directly on exposed cortical tissue during an open cranial surgical procedure to map brain function or localize seizure foci.

Anterior spinal arthrodesis for deformity correction spanning eight or more vertebral segments, with or without cast application.

Arthrodesis of the clivus-C1-C2 complex via anterior transoral or extraoral approach, with or without odontoid process excision.

Posterior spinal arthrodesis for deformity correction spanning 7 to 12 vertebral segments, with or without body cast application.

Bifrontal reconstruction of the superior-lateral orbital rims and lower forehead, with or without bone grafts including autograft harvest, for conditions such as plagiocephaly, trigonocephaly, or brachycephaly.

Kyphectomy involving circumferential spinal exposure and full resection of one or two vertebral segments, including both the vertebral body and posterior elements.

Removal and replacement of a single strut in a multiplane unilateral external fixation system that uses stereotactic computer-assisted (spatial frame) adjustment, including imaging.

Radical resection of a tumor involving a wing of the ilium, one pubic or ischial ramus, or the symphysis pubis, with removal of a margin of surrounding healthy tissue.

Reconstruction of the midface using a modified LeFort III osteotomy with internal fixation, repositioning the midface skeleton to correct severe craniofacial deformities.

Reconstruction of orbital walls, rims, forehead, and nasoethmoid complex after intra- and extracranial excision of a benign cranial bone tumor, using multiple autografts (graft harvest included); total bone graft area under 40 square centimeters.

Surgical reattachment of a completely amputated thumb, spanning the carpometacarpal joint through the MP joint, including repair of bone, vasculature, nerves, and soft tissue.

Radical resection of a tumor involving the femur or knee, including bone and surrounding soft tissue as required for oncologic margins.

Replantation of a single digit (excluding the thumb) following complete amputation, covering the metacarpophalangeal joint through the insertion of the flexor sublimis tendon.

Radical resection of tumor involving the ischial tuberosity and greater trochanter of the femur, with wide excision margins including surrounding healthy tissue.

Partial or complete resection of a lumbar vertebral body via a lateral extracavitary approach, performed to decompress the spinal cord and/or nerve roots — typically for tumor, infection, or retropulsed bone fragments.

Unilateral orbital repositioning via periorbital osteotomies with bone grafting to correct eye socket position from trauma or congenital deformity.