Summary & Overview
CPT 26230: Partial Excision of Metacarpal Bone, Hand
CPT code 26230 represents a partial excision of a metacarpal bone in the hand performed via techniques such as craterization, saucerization, or diaphysectomy. This surgical code captures targeted bone removal or contouring intended to treat localized metacarpal pathology and is relevant across hand surgery, orthopedic, and plastic surgery specialties. Nationally, the code is important for accurate procedure capture, surgical quality measurement, and appropriate reimbursement for operative management of hand conditions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, expected sites of service, and common billing modifiers associated with the code. The publication also presents national benchmarking and policy considerations relevant to payers and surgical providers, including utilization patterns, payment variability, and coding guidance implications. Clinical readers will gain clarity on the procedure’s scope and typical practice settings; billing and compliance teams will find context for payer interactions and documentation expectations.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific fee schedules.
Billing Code Overview
CPT code 26230 describes a surgical procedure in which a provider partially excises a portion of a metacarpal bone in the hand using techniques such as craterization, saucerization, or diaphysectomy. This service is a hand/orthopedic surgical procedure focused on bone removal or reshaping to address localized pathology of the metacarpal.
-
Service type: Hand/orthopedic surgical procedure involving partial metacarpal excision and contouring
-
Typical site of service: Ambulatory surgical center or hospital operating room
Data not available in the input for payers, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to the hand surgery clinic with chronic radial-sided thumb pain and progressive dorsal subluxation of the carpometacarpal joint after failed conservative care. Imaging demonstrates degenerative change and localized osteophyte formation of the base of the first metacarpal with painful focal bone prominence. The surgeon schedules a procedure to partially excise the metacarpal bone using craterization/saucerization (partial metacarpal ostectomy) to remove painful osteophyte and reshape the articular margin.
Preoperative workflow includes history and physical, review of hand and wrist radiographs, informed consent documented with the planned partial excision technique, and anesthesia evaluation (regional block or general). The procedure is typically performed in an outpatient ambulatory surgery center or hospital same-day surgery unit. Intraoperative steps include sterile prep, regional or general anesthesia, a small dorsal or radial incision, exposure of the metacarpal, partial bone excision (craterization/saucerization/diaphysectomy) to remove the symptomatic bony prominence, hemostasis, soft-tissue repair, and sterile dressing. Postoperative workflow includes short PACU recovery, hand dressing and splinting, discharge with written postoperative instructions, and a follow-up visit for wound check and hand therapy referral as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure was performed on the left hand metacarpal |