Summary & Overview
CPT 26567: Partial Excision of Finger Phalanx
Headline: CPT code 26567 defines partial excision of a finger phalanx to correct angular deformity or abnormal bone growth
Lead: CPT code 26567 represents a targeted hand surgery procedure—partial removal of a phalanx—to restore alignment or remove pathological bone in the finger. The code captures a focused orthopedic intervention with implications for surgical billing, care settings, and payer coverage nationally.
Why it matters: This code is used to document a common corrective hand surgery that can affect functional outcomes, surgical coding accuracy, and reimbursement pathways. Proper use of CPT code 26567 ensures consistent capture of procedure complexity and supports claims processing across payers.
Payers covered: Analysis includes major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides benchmarks and typical site-of-service information, clarifies clinical context for use of CPT code 26567, and summarizes payer coverage patterns and billing considerations. Readers will find concise guidance on documentation expectations, how the procedure maps to surgical service lines, and areas where policy updates may affect coding or coverage. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 26567 describes a surgical procedure in which a provider excises part of a phalanx bone of the finger to correct structural problems such as angular deformity or abnormal bone growth. This procedure is classified as an orthopedic hand surgery focused on bone resection of a digital phalanx.
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Service type: Surgical bone resection of the finger (digital phalanx osteotomy/partial excision)
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Typical site of service: Ambulatory surgical center or hospital operating room, commonly performed by hand surgeons or orthopedic surgeons
Clinical & Coding Specifications
Clinical Context
A 48-year-old right-handed patient presents with progressive angular deformity and pain of the proximal phalanx of the ring finger after a malunited fracture and osteophyte formation. Conservative measures including splinting, anti-inflammatory medication, and hand therapy have failed to relieve pain and restore alignment. Imaging (plain radiographs and optional CT) demonstrates focal bony overgrowth and angular malalignment of the phalanx consistent with symptomatic bony deformity. The surgeon schedules an outpatient operative procedure under regional block or general anesthesia to perform a partial phalangectomy of the affected phalanx to remove the deforming bone and restore alignment.
The typical clinical workflow includes preoperative evaluation and informed consent, imaging review, site marking, administration of anesthesia (digital block, brachial plexus block, or general anesthesia as indicated), excision of the abnormal segment of phalanx with preservation of soft-tissue attachments as feasible, hemostasis, potential internal fixation or soft-tissue repair if required, dressing and splinting, recovery in the ambulatory surgery unit, and postoperative hand therapy and follow-up visits for wound check and functional rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on a left finger phalanx |