Summary & Overview
CPT 26951: Digital Amputation of Finger or Thumb with Nerve Removal
CPT code 26951 represents surgical amputation of a finger or thumb at any joint or phalanx with excision of nerve tissue and direct primary wound closure. The code applies to both primary amputations performed immediately after acute injury or infection and secondary amputations performed after a prior failed healing attempt. This procedure is clinically significant because it addresses limb-threatening injury, infection, or nonhealing residual digit tissue and often determines functional and rehabilitative trajectories for patients.
Key payers in typical national coverage considerations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how CPT code 26951 is billed across typical surgical settings, expected sites of service, and common clinical indications for amputation versus preservation attempts.
Readers will find a concise clinical and billing overview, guidance on typical sites of service, the set of common modifiers associated with this surgical service (listed separately), and context for how this code fits within hand and microsurgery procedure groupings. The material also highlights what to expect in claims processing and documentation focus areas relevant to payers and providers. Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, and service-line revenue details are noted as unavailable in the input.
Billing Code Overview
CPT code 26951 describes primary or secondary amputation of a finger or thumb at any joint or phalanx level with removal of nerve tissue and direct closure of the wound. Primary amputation refers to removal performed immediately after an acute injury or infection; secondary amputation refers to removal performed after a prior amputation that failed to heal properly.
Service Type: Surgical procedure — digital (finger or thumb) amputation with nerve excision and primary wound closure
Typical Site of Service: Operating room or surgical procedure suite in an acute care hospital or ambulatory surgery center; may also be performed in an urgent care surgical setting depending on clinical circumstances.
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged adult who presents to the emergency department or hand surgery clinic after a traumatic fingertip crush with devitalized tissue and irreparable digital nerve injury, or a patient with progressive infection or nonhealing stump after a prior partial amputation. The hand surgeon evaluates circulation, sensation, tendon function, and wound viability. When salvage is not feasible or further tissue loss is expected, the surgeon performs a primary or secondary amputation of a finger or thumb at the appropriate phalanx or joint level, includes removal of nerve tissue to reduce neuroma formation, and performs direct wound closure. Typical workflow: initial assessment and stabilization, informed consent, preoperative documentation of indication and level planned, operative procedure coding as 26951, intraoperative note documenting nerve tissue excised and closure method, postoperative wound care instructions, and follow-up visits to monitor healing and function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the amputation was performed on a left finger or thumb |
RT | Right side | Use when the amputation was performed on a right finger or thumb |
50 | Bilateral procedure | Use if identical procedures are performed on both hands (rare for single-digit amputation) |
59 | Distinct procedural service | Use when a separate, distinct procedural service is performed on the same day (e.g., separate repair on another digit) |
52 | Reduced services | Use when the procedure was partially reduced or not completed as originally planned |
53 | Discontinued procedure | Use when the procedure was started but discontinued for reasons unrelated to patient recovery |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during global period |
22 | Increased procedural services | Use when work or complexity is substantially greater than typical for 26951 and documented accordingly |
26 | Professional component | Use when reporting only the physician professional component if a separate technical component exists (rare for this code) |
TC | Technical component | Use when reporting only the technical component (facility billing) if applicable |
62 | Two surgeons | Use when two surgeons work together as primary surgeons on the procedure |
76 | Repeat procedure by same physician | Use when the same procedure is repeated later same day by same physician |
77 | Repeat procedure by another physician | Use when the same procedure is repeated later same day by another physician |
79 | Unrelated procedure during global period | Use when an unrelated procedure is performed during the global period (duplicate of above if applicable) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopedic Hand Surgery | Hand and upper extremity surgeons commonly perform digital amputations |
| 207K00000X | Orthopedic Surgery | Orthopedic surgeons with hand subspecialty perform this procedure |
| 207X00000X | Surgery | General surgeons occasionally perform digital amputations in certain settings |
| 2080P0004X | Plastic Surgery | Plastic and reconstructive surgeons perform digit amputations and stump revision |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S68.01XA | Traumatic amputation of thumb, initial encounter | Primary traumatic indication for digital amputation when salvage is not possible |
S68.11XA | Traumatic amputation of index finger, initial encounter | Traumatic loss or irreparable injury to the index finger requiring amputation |
S68.12XA | Traumatic amputation of middle finger, initial encounter | Traumatic middle finger injuries leading to primary amputation |
S68.13XA | Traumatic amputation of ring finger, initial encounter | Ring finger trauma with devitalized tissue necessitating amputation |
S68.14XA | Traumatic amputation of little finger, initial encounter | Little finger traumatic amputation indication |
T79.2XXA | Traumatic compartment syndrome, initial encounter | Severe compartment syndrome with ischemic necrosis may require digit amputation |
L03.011 | Cellulitis of finger | Severe or necrotizing infection leading to secondary amputation if irrecoverable |
E10.621 | Type 1 diabetes mellitus with foot ulcer (use analogously for severe digit ulceration) | Poorly controlled diabetes with ischemic or nonhealing digit ulceration that may require amputation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11042 | Debridement; skin, subcutaneous tissue, muscle and fascia | May be performed prior to or in conjunction with amputation when extensive debridement of infected or necrotic tissue is required |
26010 | Repair, tendon sheath, flexor, primary; single tendon | May be performed on adjacent digits when tendon repair is required in the same operative session |
64450 | Injection, anesthetic agent; other peripheral nerve (e.g., digital nerve block) | Used preoperatively or intraoperatively for regional anesthesia of the finger or thumb |
20550 | Injection, therapeutic, tendon sheath, ligament, trigger point | May be used postoperatively for treatment of adjacent pain or tenosynovitis if indicated |
26123 | Amputation, metacarpal, single; including debridement and direct closure | Performed for more proximal hand amputations when disease or trauma extends proximal to phalanges |