2025 CPT code 26861

Arthrodesis of each additional interphalangeal joint of a finger, with or without internal fixation, performed in the same session as a primary arthrodesis procedure.

Always refer to the most current CPT manual and any applicable payer-specific guidelines for accurate coding and reimbursement.Code 26861 is an add-on code and must be reported with a primary procedure code (26860).Each additional joint fused requires a separate report of 26861.

Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 51 (Multiple procedures) is not applicable for this add-on code. Modifier 76 (Repeat procedure by the same physician) could be used if the procedure was repeated on the same joint.

Arthrodesis of the interphalangeal joint is medically necessary to alleviate pain and improve function in patients with severe osteoarthritis, rheumatoid arthritis, or post-traumatic instability, where conservative treatment methods have failed. Documentation of failed conservative treatments such as physical therapy, medication, and injection therapies should be provided to support medical necessity.

The orthopedic surgeon or hand surgeon is responsible for performing the arthrodesis procedure, including incision, joint preparation, fusion, fixation (if applicable), hemostasis, and wound closure. Post-operative care, including splint application and follow-up appointments, would be handled by the same physician or other qualified healthcare professional.

IMPORTANT Use in conjunction with 26860 (Arthrodesis, interphalangeal joint, with or without internal fixation).Code 26862 should be used when an autograft is used in the arthrodesis procedure.

In simple words: This code is for an extra finger joint fusion surgery.It's only used if the doctor already fused one joint in the same visit and now needs to fuse another. The doctor will fuse the bones together, making the joint stiff, which can help with arthritis pain.

This CPT code, 26861, represents an add-on code for the surgical fusion (arthrodesis) of an additional interphalangeal joint of a finger.This procedure is performed in the same session as a primary arthrodesis of an interphalangeal joint (typically coded as 26860). The surgeon may or may not utilize internal fixation devices such as pins, wires, or screws during the fusion process.The code is used for each additional joint fused beyond the initial one.The procedure involves surgical preparation and exposure of the joint, removal of articular cartilage, fusion of the joint surfaces, hemostasis, and wound closure, followed by splinting.

Example 1: A patient presents with severe osteoarthritis in the distal interphalangeal joint of the right index finger.The surgeon performs an arthrodesis of this joint (26860) and also finds significant arthritis in the proximal interphalangeal joint of the same finger requiring arthrodesis (26861).26861 is reported as an add-on code., A patient sustains a comminuted fracture of the middle phalanx of the left ring finger.Following open reduction and internal fixation (ORIF) of the fracture, the patient’s proximal interphalangeal joint is noted to be severely arthritic. An arthrodesis of this joint is performed (26860) and, given the extent of the damage, the surgeon also finds it necessary to fuse the distal interphalangeal joint of the same finger (26861). 26861 is reported as an add-on code., A patient with rheumatoid arthritis has significant instability in both the proximal and distal interphalangeal joints of the right thumb. The surgeon performs an arthrodesis on the proximal interphalangeal joint (26860) and a subsequent arthrodesis of the distal interphalangeal joint (26861) during the same surgical session.

* Preoperative diagnosis clearly indicating the need for arthrodesis of the interphalangeal joint(s).* Operative report detailing the surgical technique, including the specifics of any internal fixation used.* Anesthesia record and any complications encountered during the procedure.* Postoperative instructions given to the patient.* Documentation supporting medical necessity.

** This code is specifically for additional interphalangeal joints fused during the same session.It does not encompass the initial arthrodesis, which should be coded separately.Ensure accurate documentation to support medical necessity.

  • Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
  • RVU: This information is not readily available in the provided source and requires access to a professional medical billing database or fee schedule for specific RVU values and reimbursement information. The value varies based on geographic location, facility type, and payer.
  • Global Days : The global period for this add-on code is dependent on the global period of the primary procedure (26860). This would need to be looked up in the payer's fee schedule for the primary procedure.
  • Payment Status: Active
  • Modifier TC rule: The Technical Component (TC) modifier is not applicable to this code.
  • Fee Schedule : Historical fee schedule data for this code is not available in the provided context and would need to be obtained from professional medical billing resources or fee schedules based on the year and payer.
  • Specialties:Orthopedic Surgery, Hand Surgery
  • Place of Service:Office, Ambulatory Surgical Center (ASC), Inpatient Hospital
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.