CPT® Code 26123

Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);

The CPT® Code 26123 refers to a surgical procedure known as a partial palmar fasciectomy, which involves the excision of thickened fascia in the palm and potentially the fingers. This procedure is specifically performed on a single digit, including the proximal interphalangeal joint, and may incorporate techniques such as Z-plasty, local tissue rearrangement, or skin grafting, which includes the process of obtaining a graft if necessary. The primary goal of this procedure is to alleviate the flexion contracture of the affected finger by removing the thickened fascia that restricts movement. During the operation, a zigzag incision is typically made over the palm and the affected fingers to access the underlying structures. The surgeon carefully elevates the skin and subcutaneous tissue to expose the palmar fascia and the pretendinous fascial cord. This meticulous dissection allows for the identification and protection of the digital nerves and arteries adjacent to the tendon cords. Once the thickened fascia is fully elevated from the proximal palm to the metacarpal head, it is excised, thereby freeing the underlying tendon. The procedure concludes with the rearrangement of soft tissues in the palm to ensure adequate coverage and protection of the underlying structures, followed by the closure of the zigzag incision or the application of a skin graft if required. This code is specifically utilized when the incision extends over the proximal interphalangeal joint and involves the removal of the fascial cord from a single finger, while additional fingers treated in a similar manner would be coded separately under CPT® Code 26125.