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Official Description

Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 26615 refers to the open treatment of a single metacarpal fracture, which is a break in one of the long bones in the hand that connect the wrist to the fingers. This procedure involves making a dorsal incision, which is located on the back of the hand, directly over the fractured metacarpal bone. The surgical approach allows for direct visualization and access to the fracture site, enabling the surgeon to clear any debris and properly align the fractured bone. Once the fracture is exposed, it is reduced, meaning the bone fragments are repositioned to their normal anatomical alignment. Internal fixation may be employed to stabilize the fracture, which can involve various devices such as K wires, pins, mini-fragment screws, or a plate and screw system, depending on the specific characteristics of the fracture. The alignment of the bone can be confirmed using imaging techniques like fluoroscopy or X-ray during the procedure. It is important to note that if multiple metacarpal fractures are treated in a single session, the code 26615 should be reported for each individual bone that is treated.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of a metacarpal fracture, as described by CPT® Code 26615, is indicated for patients who have sustained a fracture in one of the metacarpal bones of the hand. The specific indications for this procedure include:

  • Single Metacarpal Fracture A fracture involving one of the metacarpal bones that may require surgical intervention for proper alignment and stabilization.
  • Displaced Fracture A fracture where the bone fragments are not aligned properly and require reduction to restore normal anatomy.
  • Fracture with Complications Instances where the fracture may be associated with complications such as significant soft tissue injury or instability that necessitates surgical fixation.

2. Procedure

The procedure for the open treatment of a metacarpal fracture involves several critical steps, which are detailed as follows:

  • Step 1: Incision A dorsal incision is made over the site of the fractured metacarpal bone. This incision allows the surgeon to access the fracture directly and is strategically placed to minimize damage to surrounding tissues.
  • Step 2: Exposure and Debridement Once the incision is made, the fracture site is carefully exposed. The surgeon clears any debris or hematoma from the area to ensure a clean field for the repair. This step is crucial for preventing infection and promoting healing.
  • Step 3: Fracture Reduction The next step involves the reduction of the fracture, where the bone fragments are realigned to their normal anatomical position. This may require manipulation of the fragments to achieve proper alignment.
  • Step 4: Internal Fixation After the fracture is reduced, internal fixation is performed as needed to stabilize the fracture. The choice of fixation device—such as K wires, pins, mini-fragment screws, or a plate and screw system—depends on the specific nature and location of the fracture.
  • Step 5: Verification of Alignment The surgeon may use fluoroscopy or X-ray imaging to verify that the anatomical alignment of the metacarpal bone has been achieved and maintained during the procedure.

3. Post-Procedure

Following the open treatment of a metacarpal fracture, patients typically require post-operative care to ensure proper healing. This may include immobilization of the hand using a splint or cast to protect the surgical site and maintain alignment during the initial healing phase. Patients are often advised on pain management strategies and may be prescribed analgesics to manage discomfort. Follow-up appointments are essential to monitor the healing process, assess for any complications, and determine when rehabilitation or physical therapy may begin to restore function and strength to the hand. The expected recovery time can vary based on the severity of the fracture and the individual patient's healing response.

Short Descr TREAT METACARPAL FRACTURE
Medium Descr OPEN TX METACARPAL FRACTURE SINGLE EA BONE
Long Descr Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 3
CCS Clinical Classification 148 - Other fracture and dislocation procedure
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
99 Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T4 Left foot, fifth digit
TA Left foot, great toe
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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