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CPT 26535: Interphalangeal Joint Reconstruction or Replacement
CPT code 26535 represents surgical reconstruction or replacement of interphalangeal joints using adjoining tissues to correct deformity, reduce inflammation, and restore function. This procedure is clinically important for patients with advanced arthritis or post-traumatic joint damage in the fingers or toes. Nationally, procedures coded with 26535 affect hand and foot surgery service lines and inform hospital and ambulatory surgery center resource planning, perioperative care pathways, and specialty-specific utilization trends.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical context, typical sites of service, and procedural intent. The publication includes benchmarking information where available, payer coverage summaries, common modifiers associated with the code, and links to related procedural guidance and coding considerations. Clinical details clarify indications such as deformity correction, inflammatory reduction, and functional improvement, while billing-focused sections outline typical service settings and operational implications for surgical practices and facilities.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes is noted where applicable.
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Billing Code Overview
CPT code 26535 describes surgical reconstruction or replacement of one or more interphalangeal joints using adjoining tissues. The procedure is performed to correct deformity, reduce inflammation, and improve function, typically for patients with arthritis or prior traumatic injury.
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Service type: Surgical joint reconstruction/replacement of interphalangeal joints
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Typical site of service: Ambulatory surgery center or hospital operating room