Arthrotomy of the metacarpophalangeal joint with exploration, drainage, or removal of a loose or foreign body through an open incision.

Verified May 8, 2026 · 7 sources ↓

Medicare: $330.00
Total RVUs: 9.88
Global, days: 90
Region: Hand

Drawn from AAPCMdclarityCMSFindacodeAssets

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Specify which metacarpophalangeal joint was operated on (e.g., index finger MCP, right hand) — vague laterality or digit identification is an audit trigger.
Document the indication clearly: septic arthritis, foreign body with description of material, or loose body — payers scrutinize medical necessity for open joint procedures.
Operative note must describe the arthrotomy approach, joint inspection findings, volume or character of drainage, and any material removed.
If infection was the indication, include pre-op labs, imaging, or aspiration results that confirm joint involvement rather than periarticular soft tissue only.
For foreign body removal, note how the foreign body was identified (imaging, exam, intraoperative finding) and its ultimate disposition.
Document closure technique and any intraoperative irrigation performed, as incomplete notes invite down-coding or medical necessity denials.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 26075 describes an open arthrotomy of the metacarpophalangeal (MCP) joint — typically performed for septic arthritis, retained foreign body, or loose body — in which the surgeon incises the joint capsule, inspects the joint space, and drains purulence or removes the offending material. This is a distinct open procedure, not an aspiration or arthroscopic approach. The 90-day global period means all routine post-op care through day 90 is bundled; anything unrelated billed in that window requires modifier 24 (E&M) or 79 (unrelated procedure).

Billing laterality modifiers LT or RT is standard practice; payers expect them and will often deny or suspend the claim without them. If the same procedure is performed on multiple MCP joints in one session — for example, index and middle finger — document each joint separately and apply modifier 59 or XS to the additional joint(s) to establish distinct anatomic sites. A same-day E&M that drove the decision to operate is not separately billable; a significant separately identifiable E&M unrelated to the operative decision requires modifier 25.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.81
Practice expense RVU	5.34
Malpractice RVU	0.73
Total RVU	9.88
Medicare national rate	$330.00
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$330.00
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 26075 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or ambiguous laterality — claim submitted without LT or RT when payer requires digit-level specificity.
Medical necessity not established — operative note lacks pre-op imaging, lab evidence, or aspiration confirming intra-articular pathology vs. soft-tissue infection.
Unbundling conflict — wound debridement (e.g., 11042) billed same-day without modifier 59 or XS to distinguish the extra-articular soft-tissue work from the joint procedure.
Global period violation — post-op E&M submitted without modifier 24 during the 90-day global window.
Site-of-service mismatch — procedure billed under facility rates when performed in an ASC, or vice versa, triggering payment recalculation or outright denial.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Is 26075 the right code if the surgeon also debrided soft tissue around the MCP joint during the same session?

Yes, but the soft-tissue debridement (e.g., 11042) is separately reportable only if it involved tissue clearly outside and distinct from the joint. Bill the debridement with modifier 59 or XS to signal a separate anatomic structure. Without that modifier, NCCI edits are likely to bundle the debridement into 26075.

02Can 26075 be billed bilaterally if both hands required MCP arthrotomy?

Yes. For physician billing, report 26075 with modifier 50 on a single claim line. For ASC facility billing, report two claim lines — one with LT and one with RT. Document both joints explicitly in the operative note.

03What modifier applies if the patient returns to the OR during the global period for re-irrigation of the same infected MCP joint?

Use modifier 78 — unplanned return to the OR for a related procedure during the postoperative period. Modifier 79 is for an unrelated procedure. Do not invert them.

04Does the 90-day global period mean no E&M can be billed for 90 days?

Not exactly. E&M visits related to recovery are bundled. An E&M for a completely unrelated condition (e.g., hypertension management) can be billed with modifier 24 to bypass the global bundle. Document the distinct, unrelated reason for the visit.

05What ICD-10 diagnoses most commonly support medical necessity for 26075?

Septic arthritis of the MCP joint (M00.0x1–M00.0x9 by organism), foreign body in hand joint (M79.5x), and loose body in finger joint are the primary indications. The diagnosis must match the intraoperative findings documented in the operative note — a soft-tissue infection code alone will not support an intra-articular procedure.

06If the surgeon performs arthrotomy on two different MCP joints on the same hand in one session, how should that be reported?

Report 26075 for the primary joint, then 26075 again with modifier 51 (multiple procedures) and modifier 59 or XS for the additional joint. Each joint entry must be documented separately in the operative note with distinct findings.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the operative dictation specific to 26075: the digit and hand identified by name and side, the arthrotomy approach, intraoperative findings (purulence volume, foreign body description, loose body characteristics), irrigation and drainage performed, and closure. It also flags when the dictation describes only periarticular debridement without confirmed intra-articular entry — the most common documentation gap that triggers medical necessity denials on MCP arthrotomy claims.

See how Mira captures CPT 26075 documentation