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Official Description

Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 20805 refers to the surgical replantation of a forearm that has been completely amputated, specifically between the wrist and elbow. This complex surgical intervention is performed under general anesthesia to ensure the patient is fully unconscious and pain-free during the operation. The process begins with the careful removal of any damaged tissue surrounding the amputation site, which is crucial for promoting healing and reducing the risk of infection. Following this, the ends of the amputated bones, namely the radius and ulna, are meticulously trimmed to facilitate a proper alignment and connection. This preparation is essential as it aids in the subsequent steps of suturing the soft tissues, including arteries, veins, nerves, muscles, and tendons, which are all critical for restoring function and sensation to the limb. In cases where there is a lack of skin coverage, a graft is utilized to protect the underlying structures. Additionally, any exposed nerves, tendons, and joints may require coverage through a free-tissue transfer, which includes its own blood supply via associated arteries and veins. Finally, the surgical site is closed in layers to ensure optimal healing and support for the reattached structures.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of replantation of the forearm, as described by CPT® Code 20805, is indicated for patients who have experienced a complete amputation of the forearm between the wrist and elbow. This may occur due to traumatic injuries such as accidents, severe lacerations, or other incidents that result in the loss of the forearm. The primary goal of this procedure is to restore the functionality and appearance of the limb, as well as to preserve the integrity of the surrounding tissues and structures.

  • Complete Amputation The procedure is specifically indicated for cases of complete amputation of the forearm, which necessitates surgical intervention to reattach the severed limb.
  • Traumatic Injury Patients who have suffered traumatic injuries leading to the loss of the forearm are prime candidates for this replantation procedure.

2. Procedure

The replantation procedure involves several critical steps to ensure the successful reconnection of the amputated forearm. Each step is designed to meticulously restore the anatomical and functional integrity of the limb.

  • Step 1: Anesthesia Administration The procedure begins with the administration of general anesthesia to the patient, ensuring they are completely unconscious and free from pain during the surgery.
  • Step 2: Tissue Preparation Once the patient is anesthetized, the surgeon carefully assesses the amputation site and removes any damaged or necrotic tissue surrounding the area. This step is vital for reducing the risk of infection and promoting healing.
  • Step 3: Bone Trimming The ends of the amputated radius and ulna bones are then trimmed to create a clean surface for reattachment. This preparation facilitates better alignment and stabilization of the bones during the replantation process.
  • Step 4: Soft Tissue Reconstruction Following the bone preparation, the surgeon proceeds to suture together the various soft tissues, including arteries, veins, nerves, muscles, and tendons. This step is crucial for restoring blood flow and nerve function to the reattached limb.
  • Step 5: Grafting In instances where there is insufficient skin coverage over the amputation site, a graft is applied to protect the underlying structures and promote healing.
  • Step 6: Free-Tissue Transfer If there are exposed nerves, tendons, or joints, the surgeon may utilize a free-tissue transfer, which includes the necessary blood supply through its associated arteries and veins, to cover these areas adequately.
  • Step 7: Layered Closure Finally, the surgical site is closed in layers, ensuring that all tissues are properly aligned and secured to facilitate optimal healing and recovery.

3. Post-Procedure

After the replantation procedure, patients typically require close monitoring in a recovery setting to assess the viability of the reattached limb. Post-operative care may include pain management, wound care, and physical therapy to regain function. Patients are advised to follow specific instructions regarding activity restrictions and care of the surgical site to promote healing and prevent complications. Regular follow-up appointments are essential to monitor the recovery process and address any concerns that may arise during the healing period.

Short Descr REPLANT FOREARM COMPLETE
Medium Descr REPLANTATION FOREARM COMPLETE AMPUTATION
Long Descr Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 164 - Other OR therapeutic procedures on musculoskeletal system

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

20702 Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure)
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.
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2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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