W4420: Complex total replacement of ankle (i.e. including custom prosthesis, wedges, internal fixation of fractures)
For guidance only. Always check the code and obtain authorisation from your insurer before treatment. Other insurers may use different codes and coding rules.
For guidance only. Procedure codes and descriptions on this site are provided for general guidance only and are not a guarantee of insurance cover or payment. Always check the correct code with your surgeon's secretary and obtain authorisation from your insurer before treatment. Insurers shown are examples only. Other insurers are available, and each may use the same, similar or different codes and coding rules.
Insurer listing
| Insurer | Status | Notes |
|---|---|---|
| Bupa | Listed | Listed by Bupa |
| AXA Health | Listed | Listed by AXA Health |
| Vitality | Listed | Listed by Vitality |
| WPA | Listed | Listed by WPA |
Codes that can't be billed with W4420
Neither code can be billed with the other
- W3100: Bone graft (as sole procedure)
- W8700: Diagnostic arthroscopic examination of joint, +/- biopsy (not otherwise specified) (as sole procedure)
- X4810: Change of cast without general anaesthetic (as sole procedure)
- X4822: Change of cast under general anaesthetic (as sole procedure)
- W9040: Injection(s) +/- aspiration, into joint, cyst, bursa - unilateral
- W0464: Complex procedure to mid foot and hindfoot with autogenous bone graft (osteotomy/fusion +/- tendon transfers, fixation)
- W9020: Dynamic arthrogram of joint
W4420 can't be billed with
AXA Health also lists these codes as unacceptable combinations (13)
- W9040: Injection(s) +/- aspiration, into joint, cyst, bursa - unilateral
- W0464: Complex procedure to mid foot and hindfoot with autogenous bone graft (osteotomy/fusion +/- tendon transfers, fixation)
- W3100: Bone graft (as sole procedure)
- W8700: Diagnostic arthroscopic examination of joint, +/- biopsy (not otherwise specified) (as sole procedure)
- W9020: Dynamic arthrogram of joint
- W8646: Multiple arthroscopic operations on ankle (including soft tissue +/- bony +/- joint surface procedures) without ligament reconstruction
- S5210: Injection into subcutaneous tissue/painful trigger point under local anaesthetic
- X4822: Change of cast under general anaesthetic (as sole procedure)
- A7350: Local anaesthetic blockade of named major nerve or plexus
- W8630: Therapeutic arthroscopy of ankle with either soft tissue procedure or bony +/or joint surface procedure (as sole procedure)
- W9030: Injection(s) +/- aspiration, into joint, cyst, bursa with image guidance - unilateral
- W8640: Complex therapeutic arthroscopy of ankle, with multiple bony, joint surface and soft tissue procedures +/- ligament reconstruction (as sole procedure)
- X4810: Change of cast without general anaesthetic (as sole procedure)
Related codes
- W4410: Total prosthetic replacement of ankle joint
- W4430: Revision of total prosthetic replacement of ankle joint
- W7880: Release of ankle joint contracture (excluding Achilles tendon lengthening)
- W6019: Ankle syndesmosis reconstruction
- W6018: Revisional ankle arthrodesis (including conversion from total ankle replacement)
- W8840: Diagnostic arthroscopic examination of ankle (as sole procedure, including anterior synovectomy to gain vision)
Frequently asked questions
What is the procedure code for complex total replacement of ankle (i.e. including custom prosthesis, wedges, internal fixation of fractures)?
The procedure code is W4420: Complex total replacement of ankle (i.e. including custom prosthesis, wedges, internal fixation of fractures).
Which insurers list W4420?
W4420 is listed by Bupa, AXA Health, Vitality and WPA. Always confirm the code and cover with your insurer.
Can W4420 be billed with other procedures?
The coding rules say W4420 cannot be billed together with 8 other codes, including W3100 (Bone graft (as sole procedure)), W8700 (Diagnostic arthroscopic examination of joint, +/- biopsy (not otherwise specified) (as sole procedure)), X4810 (Change of cast without general anaesthetic (as sole procedure)). See the full list above.
What does my procedure code mean?
For guidance only. Procedure codes and descriptions on this site are provided for general guidance only and are not a guarantee of insurance cover or payment. Always check the correct code with your surgeon's secretary and obtain authorisation from your insurer before treatment. Insurers shown are examples only. Other insurers are available, and each may use the same, similar or different codes and coding rules.
Codes and descriptions are for guidance only. Insurer listing and cover information is taken from each insurer's published schedule and is for guidance only: always confirm the code and cover with the insurer before treatment. This site is not affiliated with CCSD or any insurer. No fees are shown.
Last checked: 2026-10-01