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Official Description

Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 20962 refers to a specific surgical procedure involving the harvesting of a bone graft with microvascular anastomosis from a donor site that is not the fibula, iliac crest, or metatarsal. In this procedure, the physician carefully isolates and dissects a segment of bone while preserving the associated blood vessels, which are crucial for the graft's viability. This meticulous approach ensures that the graft can be effectively integrated into the recipient site, promoting healing and reconstruction. After the bone graft is harvested, the donor site is closed in layers to facilitate proper healing. The harvested graft is then utilized to fill a defect at another anatomical location, where it is essential for restoring structural integrity or function. The blood vessels from the graft are anastomosed, or surgically connected, to the vessels in the defect area, ensuring an adequate blood supply to the graft. Finally, the defect area is also closed with layered sutures, completing the procedure. This code is specifically designated for cases where the bone graft is obtained from sites other than the commonly used fibula, iliac crest, or metatarsal, which are covered under different CPT® codes.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 20962 is indicated for various clinical scenarios where bone reconstruction is necessary. The following conditions may warrant the use of this procedure:

  • Bone Defects The presence of significant bone loss or defects due to trauma, tumor resection, or congenital anomalies that require reconstruction.
  • Non-Union Fractures Cases where fractures have failed to heal properly and require additional support through bone grafting.
  • Osteonecrosis Conditions where bone tissue has died due to a lack of blood supply, necessitating grafting to restore function and integrity.
  • Revision Surgeries Situations where previous surgical interventions have failed, and a bone graft is needed to correct the issue.

2. Procedure

The procedure for CPT® Code 20962 involves several critical steps to ensure successful bone grafting with microvascular anastomosis. The following outlines the procedural steps:

  • Step 1: Harvesting the Bone Graft The surgeon begins by selecting an appropriate donor site that is not the fibula, iliac crest, or metatarsal. The area is prepared, and an incision is made to access the bone. The surgeon carefully dissects the bone graft while preserving the surrounding blood vessels, which are essential for the graft's viability.
  • Step 2: Closing the Donor Site Once the bone graft has been harvested, the donor site is meticulously closed in layers. This layered closure is crucial for promoting optimal healing and minimizing complications at the donor site.
  • Step 3: Preparing the Recipient Site The surgeon then prepares the defect area where the graft will be placed. This may involve debriding the site to ensure a clean surface for graft integration.
  • Step 4: Graft Placement The harvested bone graft is then positioned within the defect area. The surgeon ensures that the graft fits securely and is adequately sized to fill the defect.
  • Step 5: Microvascular Anastomosis The next step involves connecting the blood vessels from the graft to the vessels in the defect area. This microvascular anastomosis is critical for ensuring that the graft receives an adequate blood supply, which is vital for its survival and integration.
  • Step 6: Closing the Defect Area Finally, the defect area is closed with layered sutures, ensuring that the site is secure and promoting healing.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 20962, post-operative care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or graft failure. Pain management strategies are implemented to ensure patient comfort. The surgical site may require regular dressing changes, and patients are often advised on activity restrictions to promote healing. Follow-up appointments are crucial to assess the integration of the graft and the overall healing process. Rehabilitation may be necessary to restore function and strength in the affected area, depending on the specific circumstances of the surgery.

Short Descr OTHER BONE GRAFT MICROVASC
Medium Descr BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR
Long Descr Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 161 - Other OR therapeutic procedures on bone
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).
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
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2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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