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CPT®
26587

CPT® Code 26587

Official Description

Reconstruction of polydactylous digit, soft tissue and bone

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Polydactyly of the hand is a congenital condition characterized by the presence of one or more extra digits. This condition can manifest in various forms, classified primarily into three types based on the anatomical structures involved. Type I polydactyly involves only soft tissue, Type II includes bone and/or cartilage, and Type III features a complete duplication of the digit along with the metacarpal bone. Additionally, polydactyly can be categorized based on the location of the extra digit: radial or pre-axial polydactyly refers to an extra thumb, ulnar or post-axial polydactyly indicates an extra small finger, and central polydactyly involves an additional digit located in the central part of the hand. The procedure denoted by CPT® Code 26587 specifically addresses the reconstruction of a polydactylous digit that includes both soft tissue and bone. This surgical intervention is necessary to create a functional single digit from the duplicated or split digit, particularly in cases of pre-axial or post-axial polydactyly. The reconstruction process entails the excision of excess bone or cartilage, followed by the meticulous rearrangement of skin, soft tissue, tendons, joints, and ligaments to achieve a cohesive and functional digit. In cases of central polydactyly, the reconstruction is often more intricate, requiring comprehensive surgical techniques to address both the hand and the fingers effectively.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Reconstruction of a polydactylous digit is indicated in the following scenarios:

  • Polydactyly Type II - This procedure is performed when the duplicated digit includes bone and/or cartilage, necessitating surgical intervention to create a functional single digit.
  • Pre-axial Polydactyly - Indicated when there is a duplicated or split thumb that requires reconstruction to form a single, functional digit.
  • Post-axial Polydactyly - This procedure is indicated for cases involving an extra small finger that must be reconstructed to ensure proper hand function.
  • Central Polydactyly - Indicated for more complex cases where an extra digit is located in the central part of the hand, requiring extensive reconstruction of both the hand and fingers.

2. Procedure

The procedure for the reconstruction of a polydactylous digit involves several critical steps to ensure the successful formation of a single digit from the duplicated structure.

  • Step 1: Preoperative Assessment - Prior to the surgical intervention, a thorough assessment of the patient's hand anatomy is conducted. This includes imaging studies to evaluate the extent of the polydactyly and the specific structures involved, such as bone, cartilage, and soft tissue.
  • Step 2: Anesthesia Administration - The patient is administered appropriate anesthesia to ensure comfort during the procedure. This may involve local anesthesia or general anesthesia, depending on the complexity of the case and the patient's needs.
  • Step 3: Excision of Duplicated Structures - The surgeon carefully excises the duplicated digit, which may involve the removal of excess bone or cartilage. This step is crucial to prepare the site for reconstruction and to ensure that only the necessary anatomical structures remain.
  • Step 4: Soft Tissue Reconstruction - Following the excision, the surgeon rearranges the surrounding soft tissue, including skin, tendons, joints, and ligaments. This step is essential to create a functional and aesthetically pleasing single digit.
  • Step 5: Closure of the Surgical Site - Once the reconstruction is complete, the surgical site is meticulously closed using sutures. The closure technique may vary based on the extent of the reconstruction and the specific anatomical considerations.
  • Step 6: Postoperative Care Instructions - After the procedure, the patient receives detailed postoperative care instructions, including guidelines for wound care, activity restrictions, and follow-up appointments to monitor healing and function.

3. Post-Procedure

Post-procedure care is critical for optimal recovery following the reconstruction of a polydactylous digit. Patients are typically advised to keep the surgical site clean and dry, and to follow specific wound care instructions provided by the surgeon. Pain management may be necessary, and patients are often prescribed analgesics to manage discomfort. Activity restrictions are usually recommended to prevent strain on the surgical site, and patients may need to avoid using the affected hand for certain tasks during the initial healing phase. Follow-up appointments are essential to assess the healing process, evaluate the functionality of the reconstructed digit, and address any complications that may arise. Physical therapy may also be recommended to enhance mobility and strength in the hand as part of the recovery process.
Short Descr RECONSTRUCT EXTRA FINGER
Medium Descr RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE
Long Descr Reconstruction of polydactylous digit, soft tissue and 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) 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 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 2
CCS Clinical Classification 164 - Other OR therapeutic procedures on musculoskeletal system
F5 Right hand, thumb
LT Left side (used to identify procedures performed on the left side of the body)
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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