Summary & Overview
CPT 26542: Collateral Ligament Repair of Finger with Tendon Reconstruction
CPT code 26542 identifies a surgical procedure to repair a collateral ligament of the finger by reconstructing the damaged ligament using a nearby tendon, typically applied in partial tears to restore lateral joint stability. Nationally, this code is relevant to hand surgery practices, ambulatory surgical centers, and hospitals performing reconstructive procedures to preserve finger function and prevent chronic instability.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure’s purpose and common settings, billing considerations tied to surgical repair services, and operational benchmarks where available. The publication also covers common modifiers and coding considerations, payer coverage patterns, and implications for documentation and preauthorization workflows. Where input data is incomplete, the text notes "Data not available in the input." The content is intended for a national audience of coding professionals, surgical providers, and revenue cycle staff seeking a concise reference on CPT code 26542 and its role in hand/wrist reconstructive care.
Billing Code Overview
CPT code 26542 describes a surgical repair of a collateral ligament of the finger metacarpophalangeal or interphalangeal joint using a nearby tendon to reconstruct the damaged portion for cases of partial tears. This procedure is a hand/wrist surgical repair focused on restoring lateral stability of the finger joint.
Service type: Surgical — Hand/Wrist Ligament Reconstruction
Typical site of service: Ambulatory surgery center or hospital operating room, with preoperative and postoperative care delivered in outpatient surgical and hand surgery clinic settings.
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand–dominant construction worker presents with radial-sided pain and instability of the right index finger metacarpophalangeal (MCP) joint after a fall onto an outstretched hand. Clinical exam shows tenderness over the collateral ligament and laxity with valgus stress; imaging (stress radiographs or ultrasound) demonstrates a partial tear of the radial collateral ligament without joint subluxation. The patient has persistent pain and functional limitation despite 4–6 weeks of conservative care (splinting, activity modification, and hand therapy) and elects surgical repair.
The procedure performed is a collateral ligament repair of the MCP joint using a local tendon graft or tendon transfer technique to reinforce the partially torn ligament. Typical workflow includes preoperative evaluation, regional or general anesthesia, sterile hand surgery in an ambulatory surgical center or hospital outpatient department, operative repair with direct suture and tendon augmentation, intraoperative fluoroscopy as needed, and postoperative immobilization followed by hand therapy. Typical site of service is an outpatient ambulatory surgery center or hospital outpatient department; inpatient admission is uncommon for uncomplicated cases.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Append when the procedure was performed on the left hand |