2025 CPT code 26860

Arthrodesis of an interphalangeal joint, with or without internal fixation.

Consult the official CPT guidelines for appropriate code selection and modifier usage.Accurate documentation of the procedure performed is crucial for proper reimbursement.

Modifiers may be applicable depending on circumstances; for example, modifier 51 for multiple procedures, 76 for a repeat procedure, or 54 for surgical care only.

Medical necessity is established by clinical evidence of significant pain and functional impairment caused by the affected joint that is unresponsive to conservative management options.The procedure should be considered medically necessary to alleviate pain and improve the patient’s quality of life.

The orthopedic surgeon or qualified healthcare professional is responsible for the surgical procedure, including pre-operative assessment, surgical technique, and post-operative care.

IMPORTANT 26861 (additional joint), 26862 (with autograft)

In simple words: This surgery fuses a joint in your finger or toe to make it immobile, often to relieve pain from arthritis. The surgeon joins the bones together, possibly using small metal parts for support, then closes the incision and applies a splint.

This code reports the surgical fusion of an interphalangeal joint (IPJ) in a finger or toe.The procedure involves immobilizing the joint, with or without the use of internal fixation devices such as K-wires, screws, or plates.The surgeon makes an incision, dissects through subcutaneous tissue, retracts muscle, incises the joint capsule, removes any inflamed tissue, brings the bones into close proximity, and fuses the joint. Hemostasis is achieved, and the wound is closed in layers. A post-operative brace or splint is typically applied.

Example 1: A 60-year-old patient presents with severe osteoarthritis of the distal interphalangeal joint (DIP) of the right index finger, causing significant pain and limited function.Arthrodesis is performed to relieve pain and improve function. , A 45-year-old patient sustained a comminuted fracture of the PIP joint of the left middle finger in a work-related accident. Following unsuccessful attempts at non-surgical management, arthrodesis is recommended and performed to achieve joint stability., A 70-year-old patient with rheumatoid arthritis has significant pain and deformity of the DIP joint in the left thumb. Arthrodesis is performed to improve alignment and reduce pain, optimizing hand function.

Pre-operative radiographs, operative report detailing the surgical technique, post-operative radiographs, and any notes regarding the use of internal fixation devices or autograft.Patient history including pain levels and functional limitations should be documented.

** The use of autograft (26862) or additional joints (26861) should be coded separately.Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement.

  • Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
  • RVU: 18.13 RVUs (based on 2021 Medicare data)
  • Global Days : The global period is not specified in the provided text.
  • Payment Status: Active
  • Modifier TC rule: This information is not provided in the source.
  • Fee Schedule : Based on 2021 Medicare data, the total RVUs were 18.13, resulting in a national average payment of $633.Historical fee schedules will vary by payer and year.
  • Specialties:Orthopedic Surgery, Hand Surgery
  • Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)
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