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CPT®
26568

CPT® Code 26568

Official Description

Osteoplasty, lengthening, metacarpal or phalanx

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26568 refers to osteoplasty, specifically the lengthening of a metacarpal or phalanx bone. Osteoplasty is a surgical intervention aimed at reshaping or reconstructing bone structures. In this case, the focus is on lengthening the bones of the hand, which can be necessary for various clinical reasons, such as correcting congenital deformities, addressing trauma-related bone loss, or improving functional outcomes in patients with certain conditions. The procedure involves a meticulous approach where the surgeon first utilizes radiographic studies to plan the precise locations for bone cuts, ensuring optimal results. Once the surgical site is prepared, the metacarpal or phalanx is exposed, and strategic cuts are made to facilitate the distraction of the bone, effectively lengthening it. Additionally, the procedure may involve harvesting a bone autograft, typically from the iliac crest, which is the upper part of the pelvic bone. This harvested bone can be used to fill any defects created during the lengthening process, promoting healing and stability. The use of internal fixation devices, such as pins, screws, or plates, is crucial to maintain the anatomical alignment of the bone during the healing phase. In some cases, an external fixation device may also be employed to support the bone structure externally. Overall, this procedure is complex and requires careful planning and execution to achieve the desired lengthening and functional improvement of the affected bone.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of osteoplasty for lengthening the metacarpal or phalanx is indicated for several specific conditions and clinical scenarios. These may include:

  • Congenital Deformities - Conditions present at birth that affect the normal shape or length of the metacarpal or phalanx bones.
  • Trauma-Related Bone Loss - Situations where fractures or injuries have resulted in a loss of bone length or integrity, necessitating surgical intervention to restore function.
  • Functional Impairments - Cases where the length of the metacarpal or phalanx affects hand function, leading to difficulties in performing daily activities.
  • Bone Shortening Due to Disease - Conditions such as infections or tumors that may lead to the shortening of the bone, requiring lengthening to restore normal anatomy.

2. Procedure

The osteoplasty procedure for lengthening the metacarpal or phalanx involves several critical steps, each designed to ensure the successful outcome of the surgery.

  • Step 1: Preoperative Planning - Prior to the surgical procedure, the physician conducts separately reportable radiographic studies to determine the precise locations for the bone cuts. This planning phase is essential to achieve the desired lengthening and to minimize complications during surgery.
  • Step 2: Exposure of the Bone - The surgeon makes an incision to expose the metacarpal or phalanx. This step is crucial as it allows direct access to the bone for the subsequent surgical maneuvers.
  • Step 3: Bone Cuts and Distraction - Once the bone is exposed, the surgeon makes strategic cuts in the metacarpal or phalanx. These cuts facilitate the distraction of the bone, which is the process of gradually separating the bone segments to achieve lengthening.
  • Step 4: Harvesting of Bone Autograft - A bone autograft is harvested from the iliac crest. The surgeon makes a skin incision over the iliac crest, strips the muscle to reveal the bone surface, and then harvests either cortical or cancellous bone as needed for the procedure.
  • Step 5: Configuring the Graft - The harvested bone is then configured to the desired size and shape. In some cases, cancellous bone may be morselized and packed into the defect created during the lengthening process to promote healing.
  • Step 6: Internal Fixation - To secure the cut edges of the metacarpal or phalanx in anatomical alignment, the surgeon applies internal fixation devices such as pins, screws, or a plate and screw device. This stabilization is critical for the healing process.
  • Step 7: External Fixation (if necessary) - Alternatively, if indicated, a separately reportable external fixation device may be applied to provide additional support and stabilization to the lengthened bone.

3. Post-Procedure

After the osteoplasty procedure, patients typically require careful monitoring and follow-up care to ensure proper healing and recovery. Post-operative care may include pain management, wound care, and physical therapy to restore function and mobility in the hand. Patients are usually advised to avoid strenuous activities that could jeopardize the healing process. The expected recovery time can vary based on individual circumstances, including the extent of the procedure and the patient's overall health. Regular follow-up appointments are essential to assess the healing progress and to make any necessary adjustments to the treatment plan.
Short Descr LENGTHEN METACARPAL/FINGER
Medium Descr OSTEOPLASTY LENGTHENING METACARPAL/PHALANX
Long Descr Osteoplasty, lengthening, metacarpal or phalanx
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) 2 - Payment restriction for assistants at surgery does not apply 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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 2
CCS Clinical Classification 161 - Other OR therapeutic procedures on bone
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
FA Left hand, thumb
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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Pre-1990 Added Code added.
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