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Official Description

Repair macrodactylia, each digit

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Macrodactyly of the fingers refers to a condition characterized by an abnormal overgrowth of bone and soft tissue, which includes nerves, fat, and skin, resulting in one or more digits appearing significantly larger than normal. This enlargement can lead to functional impairments and aesthetic concerns for the individual. The surgical procedure coded as CPT® 26590 involves the repair of macrodactylia, specifically addressing each affected digit. The primary goal of the surgery is to reduce the size of the enlarged digit through a combination of techniques aimed at debulking the excess soft tissue and shortening the digit. This is typically achieved by excising a portion of the phalanges or the metacarpal bone, depending on the extent of the overgrowth. The procedure may be performed in stages, allowing for careful management of the surgical site and optimal healing. During the surgery, thickened layers of skin are excised to facilitate the debulking process, and skin grafts may be harvested from healthier tissue in the proximal area of the digit or hand to cover any defects created during the procedure. The overall aim is to restore both function and appearance to the affected digit, ensuring a cosmetically acceptable outcome for the patient.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure for repairing macrodactylia is indicated for patients presenting with the following conditions:

  • Macrodactyly A condition characterized by the abnormal enlargement of one or more digits, which may lead to functional limitations and cosmetic concerns.
  • Functional Impairment Patients may experience difficulties in performing daily activities due to the size of the affected digit, necessitating surgical intervention.
  • Aesthetic Concerns Individuals may seek surgery for cosmetic reasons to improve the appearance of the enlarged digit.

2. Procedure

The surgical procedure for the repair of macrodactylia involves several key steps, each aimed at effectively reducing the size of the affected digit.

  • Step 1: Debulking of Soft Tissue The initial phase of the procedure focuses on debulking the excess soft tissue. This is accomplished by excising the thickened layers of skin that contribute to the enlargement of the digit. The surgeon carefully removes these layers to reduce the overall volume of the digit.
  • Step 2: Harvesting Skin Grafts Following the debulking, skin grafts are harvested from healthy tissue located in the more proximal aspect of the digit or hand. This step is crucial for covering the defect created during the excision of the soft tissue.
  • Step 3: Configuring and Securing Skin Grafts The harvested skin grafts are then configured to fit the surgically created defect. The surgeon secures the grafts in place using sutures, ensuring proper alignment and adherence to promote healing.
  • Step 4: Shortening the Digit To achieve the desired reduction in size, the affected digit is incised over the bone that is to be excised. The surgeon dissects the soft tissues to expose the underlying bone, which is then detached from surrounding structures.
  • Step 5: Excision of Bone The surgeon excises the necessary portion of the bone, which may include one of the phalanges or the metacarpal bone, depending on the extent of the macrodactyly. This step is critical for shortening the digit effectively.
  • Step 6: Soft Tissue Management After the bone excision, any excess soft tissues are either excised or rearranged as needed to achieve a cosmetically acceptable result. This ensures that the digit not only functions properly but also appears proportionate.

3. Post-Procedure

Post-procedure care is essential for optimal recovery following the repair of macrodactylia. Patients are typically monitored for any signs of complications, such as infection or poor healing of the skin grafts. Pain management strategies are implemented to ensure patient comfort during the recovery phase. Patients may be advised to limit movement of the affected digit to promote healing and prevent stress on the surgical site. Follow-up appointments are crucial to assess the healing process and to determine if any additional interventions are necessary. The expected recovery time may vary based on the extent of the surgery and the individual patient's healing response.

Short Descr REPAIR FINGER DEFORMITY
Medium Descr REPAIR MACRODACTYLIA EACH DIGIT
Long Descr Repair macrodactylia, each digit
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
Date
Action
Notes
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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