With the changing environment of cardiac device management, appropriate and current medical coding is important for proper reimbursement and clinical documentation. G2066 CPT Code is one of those essential medical billing codes that doesn’t have high volume procedure code status, but for providers working in orthopedics or sports medicine, it’s necessary. This code is particular to removal of deep implant (e.g buried wire, pin, screw, metal band, nail, rod or plate), which necessitates open surgical access. It is important to know the correct use of CPT code 20666, as this can have an impact on the outcome of the patient, as well as get reimbursed by insurance. G2066 CPT code has been a significant part of the coding process when dealing with remote interrogation device evaluation services concerning the implantable cardiovascular physiologic monitor systems and subcutaneous cardiac rhythm monitor systems. In this detailed manual, we will outline CPT 20666 from definition and applications to documentation, reimbursement, and coding advice to pass claims involving CPT 20666.
What Is G2066 CPT Code?
Official Definition (as per AMA):
20666 – Removal of implant; deep (for example in below skin surface: buried wire, pin, screw, metal band, nail or rod or plate)
This operation is conducted using an open surgical technique, i.e., the physician has to make a cut in order to access the orthopedic hardware in the deeper layers of a person’s body like a bone or joint.
PT G2066 is the Healthcare Common Procedure Coding System (HCPCS) code used when reporting the technical component of remote interrogation device evaluations for implantable cardiovascular physiologic monitor systems, including implantable loop recorders and subcutaneous cardiac rhythm monitor systems. Specifically, it covered:
- Data acquisition is done remotely from implanted device monitors.
- Reception and technical review of communications.
- Technician support and providing the results to the interpreting physician or qualified healthcare professional
- It complemented the professional service codes CPT 93297 and 93298, which depict the physician's analysis and reporting of the device data.
When Is CPT Code 20666 Used?
CPT 20666 is used in instances where the removal of inner fixation devices will be required once the devices perform their roles, usually when the fractures are healed or when they are complicated with infection, irritation, pain, or allergic reaction.
Common Clinical Scenarios:
- Extraction of an intramedullary rod from the femur.
- Removal of a metal plate, which is used for the tibial fracture fixation.
- Deep orthopedic screws extraction from the humerus
- Surgical extraction of an internal fixation pin from the hip joint.
- Resolving implant-related infection or inflammation
Historical Evolution of CPT Code G2066
- Before 2020, the technical component had previously been charged with CPT 93299.
- In 2020, CPT 93299 was removed and replaced by HCPCS code G2066, which was MAC-priced by Medicare Administrative Contractors (MACs), thus causing regional discrepancies in reimbursement.
- G2066 was supposed to standardize being billed for the technical services of remote interrogation.
What Documentation is required for CPT G2066 (Before 2024)?
Before the deletion, appropriate documentation for billing G2066 was:
- Patient Identification and Device Details: Well-document that the type of patient’s implantable cardiac device (e.g. implantable loop recorder, subcutaneous cardiac rhythm monitor).
- Date and Time of Remote Interrogation: Document the dates on which remote transmissions were received and reviewed.
- Description of Remote Data Acquisition: Note the technical process of capturing transmissions of a device remotely, the software or the platform that is being used being mentioned.
- Technician Review and Findings: Record technician’s review on completeness and quality of the data and any technical issues experienced.
- Transmission of Results: Indications that the technician or technical personnel sent the data or summary to the interpreting physician or competent healthcare professional.
- Supporting Logs or System Reports: Attach or refer to system-generated reports that confirm the remote interrogation was done.
- Signatures: The documentation has to be signed or electronically authenticated by the technician concerned with the technical part.
- Physician or Qualified Healthcare Professional Review: While, G2066 explains the technical aspect, documentation referring to the subsequent review by the physician (reported separately in 93297 or 93298) needs to be recorded.
Reimbursement Insights: How Much Is CPT 20666 Worth?
As of 2025, Medicare Fee Schedule estimates (subject to geographic variation):
- Non-facility (office): ~$350 - $550
- Facility (hospital outpatient/ASC): ~$200 - $400
Key Factors That Impact Reimbursement:
- Place of service (POS 11 vs POS 22)
- Complexity of the procedure (could be modified)
- Combination with other procedures (eg, fracture repair)
- Payer-specific policies (specifically, Medicare Advantage and commercial payers)
CPT 20666 Modifiers: When and Why to Use
Correct modifier usage can make or break your claim.
Commonly Used Modifiers:
- Modifier 51: Multiple procedures (if performed with another distinct procedure)
- Modifier 59: Distinct procedural service (e.g., if performed in a different anatomic site)
- Modifier 78: Unplanned return to the operating room for a related procedure
- Modifier RT/LT: Laterality (right or left side)
ICD-10 Codes That Pair with CPT 20666
For successful billing, pairing the procedure code with the appropriate diagnosis code is critical.
Common ICD-10 Codes:
- 84XA: Pain due to internal orthopedic prosthetic devices
- 5XXA: Infection and inflammatory reaction due to internal fixation device
- 6: Fracture of bone following insertion of orthopedic implant
- 89: Encounter for orthopedic aftercare
- 641: Presence of right internal fixation device
Medicare and Payer Implications
Before 2024, the amount that G2066 is reimbursed depends on the MAC and leads to differences.
- After 2024, CMS has correlated payment schedules for 93297 and 93298 with the use of modifiers, which has enhanced predictability.
- The providers need to confirm payer-specific policies because commercial insurers tend to have different coding requirements.
- Precise coding ensures payment is obtained, and CMS is complied with.
Clinical and Operational Impact
- The combination of the technical and professional elements under CPT 93297 and 93298 simplifies administrative workflows.
- It improves the clarity in documentation and billing; claim denials are minimized.
- Advocates for integrated care models by laying clear roles of technicians and physicians when it comes to monitoring remote cardiac care.
- Supports capture of data for quality metrics and health outcomes research.
Common Denials for CPT Code G2066 and Related Remote Interrogation Codes
Commercial denials associated with CPT code G2066 and related codes 93297 and 93298 are mostly attributed to billing mistakes and payer-specific policies. Key reasons include:
- Duplicate Billing: The denials happen when the same provider bills technical component (-TC) and professional component (-26), both without proper modifiers and/or when multiple providers bill for the same component for the same date of service.
- Incorrect Modifier Usage: Lack or things being done in an inappropriate manner with the modifiers (-26 for professional, -TC for technical) cause claim rejections or denials.
- Use of Deleted Codes: Using Billing G2066 or CPT 93299 after their official deletion dates lead to automatic denials.
- Frequency Limit Exceeded: Some payers set bounds to the number of remote interrogations following which they can be billed in a given period; denials result from service over that limit without reasonable grounds.
- System or Processing Errors: Claims can be sent back or rejected because of system updates, lack of device information or incomplete documenting.
Best Practices for CPT Code G2066
CPT code G2066 was applied to bill the technical part in remote interrogation services of implantable monitoring devices for the heart. G2066 was, however, deleted effective from January 1, 2024, and replaced by CPT codes 93297 and 93298 with modifiers to indicate technical and professional components.
To keep accurate billings and reimbursements:
- Use Updated Codes and Modifiers: After deletion of G2066, report bill CPT 93297 or 93298 with modifier-TC for technical component and 26 for professional component. For the same service, code by a single provider bill without modifiers for the global service.
- Correct Code Selection Using the Type of Device: Use 93297 for implantable cardiovascular physiologic monitor systems; 93298 – subcutaneous cardiac rhythm monitors.
- Verify Payer Policies: Different MACs and commercial payers could have different reimbursement rates as well as frequency limits. Remain aware of payer-specific guidelines so as not to experience denials.
- Maintain Thorough Documentation: In efforts to support claims, clearly document dates and times of remote interrogations, technician activities, and physician interpretations.
- Avoid Using Deleted Codes: Do not charge G2066 or CPT 93299 after their deletion dates to avoid automatic denials.
- Coordinate Billing Among Providers: When technical and professional services are rendered by separate entities, the correct usage of their modifiers should be ensured, and there should not be double billing.
Conclusion
CPT code G2066 removal and its technical part inclusion to CPT codes 93297 and 93298 with modifiers, ease remote cardiac device monitoring billing. Best practices- accurate code choice and use of modifiers, verifying payer policy, and precise documentation help providers maximize reimbursement and minimize denial. Keeping up with updates of the coding process and coordination of billing efforts is crucial in compliance and delivery of quality patient care through remote monitoring services.
FAQ - People Also Asks
Is CPT 20666 bundled with fracture care codes?
It can be especially if the removal is part of the original surgical area. Use Modifier 59 to distinguish if it’s a separate service.
How do I bill for multiple implant removals?
If multiple implants are removed through the same incision, use 20666 once. If from different incisions/sites, use Modifier 59 or 20667 if appropriate.
Is it covered by Medicare?
Yes, but documentation must support medical necessity.