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Official Description

Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Fasciotomy, palmar (CPT® Code 26045) is a surgical procedure specifically designed to address Dupuytren's contracture, a condition characterized by the thickening and tightening of the fibrous tissue located beneath the skin of the hand and fingers. This condition leads to the development of a flexion contracture, which can make it challenging or even impossible for an individual to fully extend one or more fingers. Although Dupuytren's contracture is typically painless, the functional limitations it imposes can significantly affect a person's ability to perform daily activities. The procedure associated with CPT® Code 26045 involves an open approach, where a surgical incision is made in the palm of the hand to access the thickened fibrous tissue directly. During the surgery, the surgeon carefully incises the thickened tissue to release the contracture, allowing for improved finger extension. Following the incision, the wound is meticulously closed in layers to promote proper healing and minimize complications. This procedure is distinct from the percutaneous fasciotomy described in CPT® Code 26040, which utilizes a less invasive technique involving a small stab incision rather than a full open incision.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 26045 is indicated for the treatment of Dupuytren's contracture, which is characterized by the following conditions:

  • Flexion Contracture: The presence of a flexion contracture in one or more fingers, making it difficult or impossible to fully extend them.
  • Thickened Fibrous Tissue: The thickening and tightening of the fibrous tissue beneath the skin of the palm and fingers, which is a hallmark of Dupuytren's contracture.
  • Functional Limitations: The condition leads to significant functional limitations in hand use, impacting daily activities and quality of life.

2. Procedure

The procedure for CPT® Code 26045 involves several critical steps to effectively address Dupuytren's contracture:

  • Step 1: Anesthesia Administration The patient is positioned comfortably, and local anesthesia is administered to the palm of the hand to ensure that the area is numb and the patient remains comfortable throughout the procedure.
  • Step 2: Incision Creation A surgical incision is made in the palm of the hand, directly over the area where the fibrous tissue has thickened. This incision allows the surgeon to access the underlying tissue that is causing the contracture.
  • Step 3: Tissue Incision The thickened fibrous tissue is carefully incised. The surgeon meticulously cuts through the tissue to release the contracture, allowing for improved mobility of the fingers.
  • Step 4: Wound Closure After the fibrous tissue has been incised and the contracture released, the wound is closed in layers. This layered closure technique helps to promote optimal healing and reduces the risk of complications.

3. Post-Procedure

Following the fasciotomy procedure, patients can expect specific post-operative care and recovery considerations. The hand may be bandaged to protect the incision site, and patients are typically advised to keep the hand elevated to reduce swelling. Pain management may be necessary, and the healthcare provider will offer guidance on appropriate pain relief methods. Patients are often encouraged to begin gentle range-of-motion exercises as soon as it is deemed safe to do so, to promote healing and restore function. Follow-up appointments will be scheduled to monitor the healing process and assess the functional outcomes of the procedure. It is essential for patients to adhere to the post-operative instructions provided by their healthcare team to ensure the best possible recovery and outcome.

Short Descr RELEASE PALM CONTRACTURE
Medium Descr FASCIOTOMY PALMAR OPEN PARTIAL
Long Descr Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial
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) 1 - 150% payment adjustment for bilateral procedures applies.
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) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
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).
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.
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.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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.
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.)
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
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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
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