Summary & Overview
CPT 24357: Percutaneous Needle Tenotomy for Tendon Scar Contracture
CPT code 24357 denotes a percutaneous needle tenotomy (tendon fenestration) performed to disrupt scar tissue at an enthesis, with the goal of improving vascularization and reducing tendon contracture. Nationally, this code captures a minimally invasive soft-tissue intervention used across outpatient and ambulatory surgical settings for chronic tendinopathy and post-surgical scar-related contractures. It matters because it represents a common, low-resource procedure that can affect utilization patterns, outpatient procedure volumes, and coding consistency for tendon interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical settings, a summary of payer coverage considerations, common modifiers associated with procedural billing, and context for related service lines. The publication highlights benchmarks for utilization and reimbursement trends where available, discusses coding clarity and documentation needs relevant to payers, and provides clinical context to help billing and compliance teams align claims with procedural indications.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes is noted where applicable.
Billing Code Overview
CPT code 24357 describes a percutaneous needle tenotomy aimed at breaking up scar tissue at an enthesis by repeatedly fenestrating the tendon insertion. The procedure’s intent is to improve local vascularization and relieve tendon contracture caused by scar formation.
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Service type: Percutaneous needle tenotomy / tendon fenestration
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Typical site of service: Outpatient procedural setting, ambulatory surgery center, or office-based procedure room where percutaneous soft-tissue interventions are performed.
Clinical & Coding Specifications
Clinical Context
A 48-year-old right-hand dominant carpenter presents with focal pain and restricted motion at the dorsal wrist and base of the index finger following a tendon repair surgery six months prior. Conservative measures including activity modification, nonsteroidal anti-inflammatory drugs, and supervised physical therapy have failed to restore full tendon glide. On exam there is a painful, palpable thickened enthesis with limited tendon excursion consistent with adhesion/scar contracture. The clinician elects to perform percutaneous needle tenotomy (enthesis needling) to mechanically disrupt scar tissue, stimulate neovascularization, and improve tendon gliding.
Procedure workflow: the patient is positioned in a minor procedure room or ambulatory surgery center; the site is prepped and local anesthesia (or monitored anesthesia care if indicated) is administered. Under sterile technique, the clinician inserts a fine needle into the enthesis/adhesion area and performs multiple fenestrations to break scar bands. The site is dressed and the patient undergoes a short period of supervised active/passive range-of-motion and a tailored post-procedure rehabilitation plan is provided. Typical site of service is an outpatient clinic procedure room, ambulatory surgery center, or office-based surgical suite.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician’s professional service is billed separate from technical components. |