CPT® Code 26536

The procedure described by CPT® Code 26536 refers to an arthroplasty of the interphalangeal joint that involves the placement of a prosthetic implant. This surgical intervention is performed on the interphalangeal (IP) joint, which is the joint located between the phalanges (bones) of the fingers and toes. The procedure begins with an incision made over either the dorsal (back) or volar (front) aspect of the joint, allowing access to the underlying structures. During the surgery, careful dissection of the soft tissues is performed to expose the tendons while protecting the surrounding blood vessels and nerves. In contrast to CPT® Code 26535, which describes arthroplasty without the use of a prosthetic implant, CPT® Code 26536 specifically involves the replacement of the diseased joint with a prosthetic implant. The surgical steps include exposing and incising the joint capsule, excising any diseased joint tissue and bone spurs, and smoothing the articular cartilage. The joint is then flushed with sterile saline to remove any debris. Once the joint is adequately prepared, the procedure continues with the excision of the head of either the proximal or middle phalanx, depending on which IP joint is being addressed. The proximal and middle or middle and distal phalanges are sized, and the centers of each bone are drilled to prepare for the insertion of the implant stems. A temporary prosthetic joint is utilized to verify the correct size before the permanent implant is inserted. The fit and movement of the permanent implant are checked to ensure proper placement before it is permanently seated in the joint. Finally, the soft tissues and skin are closed in layers, completing the procedure. This code is specifically used for each IP joint treated with arthroplasty and the implantation of a prosthetic joint, highlighting the complexity and specificity of the surgical intervention.