Why hand surgery is covered
Insurance pays for surgery that brings back a function you have lost. It does not pay for surgery that only changes how you look.
Hand surgery is almost always the first kind. Think of a hand that cannot grip, or a thumb that cannot pinch. Fingers that will not straighten. A palm that goes numb at three in the morning. These are real losses, and a doctor can measure them. That is what reconstructive coverage exists for.
The confusion makes sense. Hand surgeons train through plastic surgery, orthopedic surgery, or general surgery. So when the sign outside says plastic surgery, people assume cash only. In this practice the opposite is true. Hand cases are some of the most straightforward insurance conversations we have.
What is covered, one problem at a time
Carpal tunnel release
A nerve is compressed at the wrist, and your thumb, index, and middle fingers go numb or tingle. It often wakes you at night. Over time the hand gets weaker, you start dropping things, and buttons become difficult.
This is covered. Most plans want to see that you tried simpler steps first. That might be wearing a splint at night, or changing how you use the hand.
Dr. Hurwitz performs endoscopic carpal tunnel release. It reaches the ligament through one small incision, instead of a longer cut across the palm. Most patients have less soreness and get back to normal sooner. Both approaches are covered. Which one you need is a medical decision. If this is your problem, there is a full article on carpal tunnel cost and recovery.
Cubital tunnel release
The same kind of problem, one joint higher. A nerve is compressed at the elbow, and the ring and small fingers go numb. Left alone too long, the hand weakens and the muscles begin to shrink. Covered on the same logic.
Trigger finger release
A tendon catches inside its sheath, so the finger locks and then snaps straight. It is painful, it is mechanical, and it is easy to identify.
This is covered. Before surgery we almost always try a steroid injection first. The goal of that injection is to settle the trigger finger for good, with no surgery at all. It works for many people, though it does not work for everyone. Surgery is for the fingers the injection does not resolve.
Dupuytren's contracture
Tough cords form in the palm and slowly pull the fingers down toward it. The hand will not lie flat. It may not fit into a glove or a pocket. Shaking hands becomes awkward.
Treatment is covered. There are two options here: Xiaflex, an FDA-approved injection that dissolves the cord without any incision, or surgery to release it.
Which one fits depends on where the cord sits, how far the finger has bent, and what you need the hand to do. For the injection, plans often ask how bent the finger is. That is something we measure in the office and write down.
Thumb arthritis (CMC)
Arthritis at the base of the thumb is common, and it can be genuinely limiting. The thumb is part of almost every grip you use. Opening jars, turning keys, gripping a doorknob, holding a phone.
We start with simpler care: a splint, changing certain activities, sometimes an injection. When that stops helping, there are good surgical options. One is the TOUCH CMC 1 thumb joint replacement, an implant approved by the FDA in 2025 and used more than 150,000 times worldwide.
Replacing a worn-out joint restores function, so it is reconstructive. Because the implant is relatively new, it is worth confirming your own plan's position rather than assuming.
Everything else
Ganglion cysts that hurt or limit motion. Cut tendons and nerves. Broken bones, infections, lumps, and repairs after an injury. All covered. Sudden injuries usually do not require the run-up of simpler treatments that long-term problems do.
What "try other things first" really means
For most long-term hand problems, plans want proof you tried the simple route first. That means a splint, hand therapy, changing activities, a steroid injection, or anti-inflammatory medicine.
Two things are worth understanding about this.
First, it is not just red tape. A good number of trigger fingers settle with an injection, and early carpal tunnel sometimes improves with steady night splinting. Going straight to surgery would mean operating on people who did not need it.
Second, it only counts if it is written down. Say you wore a brace for six months, but never mentioned it at a visit. As far as your insurance company is concerned, it did not happen. Tell your regular doctor about the symptoms, ask for a referral, and let the record build. If you have already done therapy or worn a splint, bring those records to your visit.
The problem is almost never that patients did too little. It is that what they did was never written down anywhere a claims reviewer could find it.
Waiting has a cost
The paperwork can hide something that matters more than the paperwork does.
Nerve compression gets worse over time. If the compression is bad enough, for long enough, the nerve can be damaged. Surgery cannot always undo that. Surgery reliably stops the problem from getting worse, and it usually relieves the night symptoms. But how much feeling and strength come back depends on how much damage was already done.
The same is true of a Dupuytren's cord left to tighten, and of an arthritic thumb whose surrounding ligaments have stretched out.
There is no appeal process for lost time. Say your hand has been going numb at night for two years. The useful step is to have it looked at now, while there is still something to protect.
How to start
Dr. Hurwitz is fellowship-trained in hand and upper-limb surgery, and takes all major insurance plans. Our team checks your benefits before your visit. You arrive knowing what your plan covers and what it asks for.
Bring whatever you already have: therapy notes, old imaging, nerve test results, and a list of what you have tried and for how long.
Bring one more thing as well — a sentence describing what your hand stops you from doing. That sentence is often the most useful item in the entire chart.