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Official Description

Removal of foreign body in muscle or tendon sheath; simple

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 20520 involves the removal of a foreign body that has become lodged within a muscle or tendon sheath. This is classified as a simple removal, indicating that the procedure does not involve extensive dissection or complications. The physician typically performs this procedure when a patient presents with a foreign object that may cause pain, inflammation, or other complications if left untreated. The process begins with the physician making an incision above the area where the foreign body is located. Through this incision, the cutaneous tissue is carefully dissected to access the foreign body. Once the foreign object is located, it is removed from the muscle or tendon sheath. After the removal, the site is assessed for infection; if no infection is present, the incision site is closed. However, if there is evidence of infection, the site may be left open and packed with gauze to promote healing and prevent further complications. It is important to note that if radiologic imaging is required to locate the foreign body, this service should be reported separately. For cases where the removal is more complex or involves deeper structures, CPT® Code 20525 should be used instead of 20520.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 20520 is indicated for the removal of foreign bodies that have become embedded in muscle or tendon sheaths. The following conditions may warrant this procedure:

  • Foreign Body Presence The patient has a foreign object, such as a splinter, metal fragment, or other debris, lodged within the muscle or tendon sheath that requires surgical intervention for removal.
  • Pain or Discomfort The presence of the foreign body is causing significant pain, discomfort, or functional impairment in the affected area, necessitating removal to alleviate symptoms.
  • Infection Risk There is a potential risk of infection or inflammation due to the foreign body, which could lead to further complications if not addressed promptly.

2. Procedure

The procedure for the removal of a foreign body in muscle or tendon sheath, as described by CPT® Code 20520, involves several key steps:

  • Step 1: Preparation The patient is positioned appropriately, and the area surrounding the foreign body is prepared and sterilized to minimize the risk of infection during the procedure.
  • Step 2: Incision The physician makes a precise incision above the affected area where the foreign body is located. This incision allows access to the underlying tissues.
  • Step 3: Dissection The cutaneous tissue is carefully dissected to expose the muscle or tendon sheath. This step requires attention to detail to avoid damaging surrounding structures.
  • Step 4: Removal of Foreign Body Once the foreign body is located, the physician removes it from the muscle or tendon sheath. This step is crucial to ensure that all fragments are completely extracted to prevent recurrence of symptoms.
  • Step 5: Site Assessment After the removal, the site is assessed for any signs of infection. If no infection is present, the incision site is closed using appropriate suturing techniques.
  • Step 6: Management of Infection If there is evidence of infection, the site may be packed open with gauze to facilitate drainage and healing, preventing further complications.

3. Post-Procedure

Post-procedure care following the removal of a foreign body using CPT® Code 20520 includes monitoring the incision site for signs of infection, such as increased redness, swelling, or discharge. Patients may be advised to keep the area clean and dry, and to follow any specific wound care instructions provided by the physician. Pain management may be necessary, and the physician may prescribe analgesics as needed. Follow-up appointments may be scheduled to assess healing and ensure that no complications arise. If the site was packed open due to infection, additional care instructions will be provided to promote proper healing and prevent recurrence of infection.

Short Descr REMOVAL OF FOREIGN BODY
Medium Descr REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
Long Descr Removal of foreign body in muscle or tendon sheath; simple
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 2
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons

This is a primary code that can be used with these additional add-on codes.

77002 CPT Add On MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
E1 Upper left, eyelid
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T5 Right foot, great toe
T8 Right foot, fourth digit
TA Left foot, great toe
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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