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Official Description

Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 26670 refers to the closed treatment of a carpometacarpal (CMC) dislocation, specifically for joints other than the thumb, and is performed without the use of anesthesia. A carpometacarpal dislocation occurs when the bones at the base of the fingers, where they meet the wrist, become displaced from their normal position. This procedure involves the manual manipulation of the dislocated joint to restore it to its proper alignment. The treatment is considered 'closed' because it does not require any surgical incisions; instead, the physician uses hands-on techniques to realign the bones. Radiographs, or X-rays, are typically obtained to assess the extent of the injury and confirm the dislocation. The manipulation is achieved through a method known as longitudinal traction, which involves pulling on the finger while applying pressure to the base of the metacarpal bone. Following the reduction of the dislocation, the affected finger may be immobilized using a splint to ensure stability during the healing process. It is important to note that if multiple CMC dislocations are treated, each dislocation is reported separately. This code is specifically applicable when the procedure is performed without anesthesia, distinguishing it from CPT® Code 26675, which is used when anesthesia is administered during the procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of carpometacarpal dislocation, as described by CPT® Code 26670, is indicated for patients presenting with dislocations of the carpometacarpal joints, excluding the thumb. The common symptoms that may lead to this procedure include:

  • Pain and Swelling: Patients often experience significant pain and swelling at the base of the affected finger, which may limit mobility and function.
  • Deformity: Visible deformity of the finger may be present, indicating a dislocation that requires intervention.
  • Loss of Function: The inability to move the affected finger or perform normal activities due to the dislocation.

2. Procedure

The procedure for closed treatment of a carpometacarpal dislocation involves several key steps, which are detailed as follows:

  • Step 1: Assessment and Imaging Before the treatment begins, the physician will assess the patient's condition and obtain radiographs to confirm the diagnosis of a carpometacarpal dislocation. This imaging is crucial for evaluating the extent of the injury and planning the appropriate treatment.
  • Step 2: Manual Reduction The physician will then perform the closed reduction of the dislocated joint. This is achieved through a technique known as longitudinal traction, where the physician applies a pulling force on the finger while simultaneously exerting manual pressure on the base of the metacarpal bone. This manipulation aims to realign the dislocated joint back into its proper anatomical position.
  • Step 3: Stabilization After successfully reducing the dislocation, the physician may immobilize the finger using a splint. This immobilization is essential to maintain the joint in its corrected position and to facilitate healing.

3. Post-Procedure

Following the closed treatment of a carpometacarpal dislocation, patients are typically advised on post-procedure care to ensure optimal recovery. This may include instructions on how to care for the splint, recommendations for pain management, and guidance on when to follow up for further evaluation. Patients should be monitored for any signs of complications, such as increased pain, swelling, or changes in circulation to the finger. The expected recovery time may vary depending on the severity of the dislocation and the individual patient's healing process, but immobilization is generally maintained until the physician determines that the joint has stabilized adequately.

Short Descr TREAT HAND DISLOCATION
Medium Descr CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES
Long Descr Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia
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) 0 - 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 Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 2
CCS Clinical Classification 148 - Other fracture and dislocation procedure
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).
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.
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
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
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)
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
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Notes
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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