Partial palmar fasciectomy with release of a single digit including the proximal interphalangeal joint — with or without Z-plasty, local tissue rearrangement, or skin grafting (graft harvest included).

Verified May 8, 2026 · 7 sources ↓

Medicare: $781.25
Total RVUs: 23.39
Global, days: 90
Region: Hand

Drawn from CMSAAPCDupuytrensAetnaEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Identify the specific digit(s) involved by name and laterality (e.g., left ring finger)
Describe the extent of palmar fascia excised — partial resection must be explicit, not implied
Document PIP joint release separately if performed, including the technique used
Specify the closure method: primary closure, Z-plasty, local flap, or skin graft — graft site if applicable
Record neurovascular structures (digital nerves, arteries) identified and protected during dissection
State the preoperative diagnosis with functional impairment — passive extension deficit in degrees strengthens medical necessity
Note prior non-surgical treatment attempts if relevant to justify surgical intervention

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 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 ↓

26123 covers removal of diseased palmar fascia combined with PIP joint release for one finger. The classic indication is Dupuytren's contracture when the cord extends from the palm into a single digit and the PIP joint requires release to restore full extension. Wound closure may involve primary suture, Z-plasty, local flap, or skin graft — all of which are bundled into 26123. Billing a separate skin graft code (e.g., 14040, 15240) alongside 26123 is unbundling.

For multi-digit disease, add 26125 for each additional digit. 26125 is an add-on code — do not append modifier 51. Do not stack 26121 with 26123; partial palmar fasciectomy is already included in 26123 by definition. Digit modifiers (F-series) are required by some payers to identify the specific finger(s) involved — confirm by payer before submitting without them.

The 90-day global period covers all routine post-op care through day 90. Separate E/M visits in that window require modifier 24. If a new, unrelated procedure is performed during the global, use modifier 79. A return to the OR for a related complication (e.g., wound dehiscence repair) takes modifier 78.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	10.61
Practice expense RVU	10.76
Malpractice RVU	2.02
Total RVU	23.39
Medicare national rate	$781.25
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	$781.25
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 26123 get rejected.

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

Unbundling: 26121 billed alongside 26123 for the same hand — partial palmar fasciectomy is included in 26123
Skin graft codes (14040, 15240) billed separately when graft is part of the Dupuytren's repair — these are bundled
Missing digit modifier when payer policy requires F-series modifiers for finger-level specificity
Modifier 51 appended to add-on code 26125, causing edit-triggered denial or repricing
Insufficient documentation of PIP joint involvement — payers may downcode to 26121 without evidence of digital release
No documentation of functional impairment or failed conservative treatment to support medical necessity

Frequently asked questions

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

01Can I bill 26121 and 26123 together for the same hand?

No. 26123 already includes partial palmar fasciectomy. Billing 26121 in addition is unbundling. Use 26123 as the primary code when both the palm and at least one digit are involved.

02How do I code Dupuytren's involving the palm, ring finger, and small finger?

Bill 26123 for the palm plus one digit (e.g., ring finger), then 26125 for each additional digit (small finger). Do not append modifier 51 to 26125 — it is an add-on code. Some payers require F-series digit modifiers; verify by payer.

03Is the skin graft separately billable when performed during a Dupuytren's fasciectomy?

No. Z-plasty, local tissue rearrangement, and skin grafting — including graft harvest — are all bundled into 26123. Reporting 14040 or 15240 in addition is unbundling and will be denied.

04Which digit modifiers should I use with 26123?

Use F-series modifiers (e.g., F3 for ring finger, F4 for small finger) when payer policy requires them. LT or RT alone is not sufficient for payers who need digit-level granularity. Check payer-specific requirements — Medicare generally accepts claims without F modifiers, but many commercial payers require them.

05What modifier applies if the patient returns to the OR during the 90-day global for a wound complication related to the original surgery?

Use modifier 78. That signals an unplanned return to the OR for a related procedure during the postoperative period. Modifier 79 is for unrelated procedures — do not use 79 for complications tied to the original fasciectomy.

06Does 26123 cover both hands if operated on in the same session?

Bilateral fasciectomy in a single session is unusual but codable. Append modifier 50 for simultaneous bilateral procedures, or bill with LT and RT on separate lines per payer preference. Modifier 50 requires prior authorization with some commercial payers for hand surgery.

07What ICD-10 diagnosis code supports 26123 for Dupuytren's contracture?

M72.0 (Palmar fascial fibromatosis — Dupuytren's) is the standard diagnosis code. Laterality is not differentiated within M72.0, so use digit and side modifiers at the procedure code level to convey specificity.

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 specific digit and laterality, the extent of palmar fascia removed, whether the PIP joint was released, and the closure technique (Z-plasty, local flap, or graft). It also flags whether additional digits were treated — prompting the coder to add 26125 per digit. This prevents the two most common audit triggers: missing digit-level specificity and undocumented PIP joint release that leads to downcoding to 26121.

See how Mira captures CPT 26123 documentation