Summary & Overview
CPT 26756: Distal Phalangeal Fracture Fixation, Percutaneous
Headline: CPT code 26756: Percutaneous fixation for distal phalangeal fractures
Lead: CPT code 26756 represents closed treatment of distal phalangeal fractures of the finger or thumb using percutaneous screws, wires, or pins. The code captures a commonly performed hand surgery technique to stabilize small bone fragments and restore function.
CPT code 26756 matters nationally because distal phalangeal fractures are frequent injuries encountered across emergency, outpatient, and surgical settings, and percutaneous fixation is a standard option when closed reduction alone is insufficient. Payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: This publication provides clinical context for when percutaneous skeletal fixation is billed using CPT code 26756, describes typical sites of service and service type, and summarizes payer coverage considerations and commonly used modifiers (listed separately). It also outlines benchmarking and policy topics relevant to hand fracture fixation, including utilization patterns, site-of-service implications, and documentation points that influence claim adjudication.
Data limitations: Data not available in the input for associated taxonomies, specific ICD-10 pairings, and detailed payer-specific coverage rules.
Billing Code Overview
CPT code 26756 describes closed treatment of a distal phalangeal fracture of the finger or thumb with percutaneous skeletal fixation. The procedure involves stabilization of a fractured distal phalanx using screws, wires, or pins that are placed through the skin to align and secure the bone fragments.
Service type: Fracture fixation — percutaneous skeletal fixation
Typical site of service: Ambulatory surgical center or hospital outpatient/inpatient setting, and occasionally the emergency department or procedure room depending on clinical needs and patient condition.
Clinical & Coding Specifications
Clinical Context
A 28-year-old right-hand–dominant male presents to the emergency department after a fall onto an outstretched hand during a recreational soccer match. He reports immediate pain, swelling, and deformity of the distal phalanx of the left index finger. Physical exam shows focal tenderness at the distal phalanx, limited active range of motion, and a small puncture wound from a fractured nail bed. Radiographs confirm a displaced transverse distal phalangeal fracture with volar comminution. After discussion of treatment options, the orthopedic hand surgeon performs closed reduction and percutaneous fixation using a single K-wire passed through the skin to stabilize the distal phalanx under local block and fluoroscopic guidance.
The clinical workflow includes initial ED evaluation, imaging with finger radiographs, informed consent, preparation in a procedure or minor operating room, administration of local/regional anesthesia, closed reduction, percutaneous placement of wires or pins, fluoroscopic confirmation of alignment, wound care for any nail bed injury, application of a protective dressing or splint, and scheduling follow-up for pin removal and rehabilitation. Documentation includes preoperative diagnosis, indication for fixation, anesthesia type, procedure details (number/type of wires or pins, fluoroscopic use), laterality, complications (if any), and postoperative instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left finger or thumb. |