Summary & Overview
CPT 26548: Repair of Torn Volar Plate, Palmar Ligament Sheath
CPT code 26548 represents the surgical repair of a torn volar plate or thickened palmar ligament sheath at the finger joints using sutures. This hand surgery procedure addresses instability and functional impairment caused by traumatic or degenerative injury to the volar plate and is commonly performed in ambulatory surgical centers or hospital operating rooms. Nationally, accurate coding for this procedure matters for consistent billing, appropriate service categorization, and ensuring patients receive timely surgical management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and the common administrative elements associated with billing this code. The publication provides benchmarks and comparative coverage considerations, concise explanations of coding scope, and policy-relevant points that affect payer adjudication and documentation expectations.
The report is intended for billing professionals, surgical providers, and policy analysts who need a clear summary of the code’s clinical intent, service setting, and payer landscape. Data not available in the input is explicitly noted where applicable in supporting tables and appendices.
Billing Code Overview
CPT code 26548 describes surgical repair of a torn volar plate or thickened palmar ligament sheath at the interphalangeal joint or the metacarpophalangeal–proximal phalanx joint. The procedure involves direct repair of the volar plate using sutures to restore joint stability and prevent recurrent subluxation or flexion contracture.
Service Type: Hand surgery / soft-tissue repair
Typical Site of Service: Ambulatory surgical center or hospital operating room; may be performed in an outpatient surgical setting for hand and finger injuries.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28-year-old who sustains a hyperextension injury to the finger during sports, presenting with pain, swelling, and instability at the proximal interphalangeal (PIP) joint. Physical exam demonstrates tenderness on the palmar aspect of the PIP joint and limited active range of motion; imaging (plain radiographs, and sometimes ultrasound) rules out a displaced fracture but suggests volar plate disruption. After failed conservative management or when there is significant instability, the patient is scheduled for operative repair. In the ambulatory surgery center or hospital outpatient operating room, the surgeon performs a volar plate repair using local, regional, or general anesthesia. The procedure includes a palmar incision over the PIP joint, identification of the torn volar plate, débridement as needed, and suture repair to the proximal phalanx or adjacent soft tissue to restore joint stability. Postoperative care includes splinting or controlled motion protocols, pain management, and hand therapy referrals. Typical sites of service are the ambulatory surgery center or hospital outpatient department. The service type is operative hand surgery focused on repair of the volar plate at a PIP joint.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
-59 | Distinct Procedural Service | When another procedure at the same session is distinct and not ordinarily reported together with the primary procedure (use with caution per correct usage guidelines). |