2026 CPT Code Updates for Orthopaedic Surgery
- hstout57
- Mar 16
- 2 min read
The 2026 CPT code updates reflect a significant shift toward modernizing orthopedic and neurological surgical reporting. From advanced limb-lengthening technology to specific guidelines for spinal repairs, these changes—summarized from recent expert presentations—ensure that coding accurately captures current medical practices.
New Spine and Nerve Decompression Codes
A major addition for 2026 is the creation of a specific add-on code for annular defect repairs.
CPT 63032: This code covers the repair of an annular defect using a bone-anchored closure device in the lumbar spine.
Clinical Note: It is an add-on to parent code 63030.
Usage: Reported once per session and cannot be billed alongside 63042.
CPT 64728: A new percutaneous decompression code for the median nerve at the tunnel, which includes ultrasound guidance and intracarpal tunnel balloon dilation.
Advancements in Limb Lengthening
To better align with the use of externally controlled devices, two new codes have been established, while an outdated code has been retired.
CPT 27458: Unilateral femur osteotomy with insertion of an externally controlled intramedullary lengthening device.
CPT 27713: Unilateral tibia osteotomy (including fibula) with the same device technology.
Deletion: CPT 27468 (femur osteoplasty with segment transfer) has been deleted as it no longer reflects standard practice.
Joint Replacement and Arthroplasty Updates
New and revised codes provide clearer pathways for reporting joint procedures.
CPT 1003T: A new Category III code for first carpometacarpal joint arthroplasty (total joint replacement).
Code Revisions (27278 & 27279):
27278: Now specifically for intra-articular implants that do not pierce the cortices.
27279: Now for implants that do pierce the cortices. For hybrid procedures, 27279 is the default choice.
Obsolete Deletion: CPT 27445 (hinge prosthesis knee arthroplasty) has been removed because the prosthesis has been off the market for decades
