Summary & Overview
CPT 26746: Open Treatment of Articular Finger Joint Fracture
CPT code 26746 describes the open surgical treatment of an articular fracture involving a metacarpophalangeal (MCP) or interphalangeal (IP) joint, typically confirmed with intraoperative or preoperative X‑rays and often stabilized with internal fixation devices such as pins, wires, or screws. This code matters nationally because injuries to finger joints are common in trauma and hand surgery, and correct coding affects clinical documentation, surgical quality metrics, and appropriate payment across different payer types. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical scope of CPT code 26746, typical settings where the service is performed, and the elements that justify reporting the code. The publication provides benchmarks and coding context for surgical management of articular finger fractures, highlights national payer coverage patterns and policy considerations, and summarizes common billing and documentation factors relevant to hospitals and ambulatory surgical centers. Data not available in the input is noted where applicable, and the content focuses on clinical and coding context rather than clinical recommendations.
Billing Code Overview
CPT code 26746 describes an open treatment of an articular fracture involving a metacarpophalangeal or interphalangeal joint. The procedure includes confirmation of the fracture with X‑rays and may involve internal fixation using implants such as pins, wires, or screws.
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Service type: Open surgical fracture repair of finger joints (metacarpophalangeal or interphalangeal) using internal fixation
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 36-year-old right-hand-dominant construction worker presents to the emergency department after a fall from a ladder with direct impact to the left index finger. Plain radiographs demonstrate a displaced intra-articular fracture of the proximal phalanx at the metacarpophalangeal joint with step-off and joint incongruity. After initial assessment, tetanus status verification, and neurovascular exam, the patient is consented for operative management. In the operating room under regional block or general anesthesia, the surgeon obtains intraoperative fluoroscopic X‑rays to confirm fracture pattern, performs an open reduction, and uses small-diameter pins and a headless compression screw to restore articular congruity and stabilize the fracture. Postoperative care includes wound management, splinting, and hand therapy referral for early range-of-motion as indicated. Typical sites of service for 26746 include an ambulatory surgery center or hospital operating room. The service type is operative orthopedic hand surgery focused on open treatment of an articular metacarpophalangeal or interphalangeal joint fracture.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's professional component (interpretation) separate from the technical facility component of imaging or other services related to the procedure. |