Summary & Overview
CPT 25272: Delayed Extensor Tendon or Muscle Repair, Forearm/Wrist
CPT code 25272 denotes a delayed surgical repair of an extensor tendon or muscle in the forearm or wrist performed after an initial traumatic injury. This procedure is clinically important because delayed tendon reconstruction carries distinct operative complexity, rehabilitation needs, and implications for functional outcomes. Nationally, management of delayed tendon injuries affects surgical resource use in ambulatory surgery centers and hospital outpatient departments and factors into payer coverage and coding decisions.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for delayed extensor tendon repair, typical sites of service, and common billing considerations tied to this code. The publication also summarizes benchmarking information, payer coverage patterns where available, and recent policy or coding clarifications that influence how CPT code 25272 is used in practice. Where input data are incomplete, the document notes those gaps explicitly as "Data not available in the input." This summary is intended to inform billing managers, orthopedic and hand surgeons, and policy analysts about the role and practical use of CPT code 25272 in national billing and coverage workflows.
Billing Code Overview
CPT code 25272 describes a delayed repair of an extensor tendon or muscle in the forearm or wrist performed after the passage of time from the original traumatic injury. This procedure involves surgical reapproximation and reconstruction of the extensor tendon or muscle when primary, acute repair was not performed or was unsuccessful.
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Service type: Surgical tendon/muscle repair (delayed)
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Typical site of service: Hospital outpatient department or ambulatory surgery center; may also occur in an inpatient setting depending on clinical complexity and comorbid conditions.
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand-dominant male presents to the orthopedic hand clinic 6 weeks after a workplace laceration to the volar-radial forearm sustained when a glass shard cut his wrist. Initial emergency care focused on hemostasis and wound care; tendon injury was noted but definitive repair was delayed due to soft-tissue swelling and partial contamination. The patient now reports weakness in active wrist and finger extension, a drooping wrist, and functional impairment of the affected hand. Examination demonstrates loss of active extension at the wrist and fingers consistent with extensor tendon disruption in the distal forearm/wrist. Electrodiagnostic studies are not required; the surgeon schedules a delayed extensor tendon repair.
The clinical workflow includes: initial evaluation and imaging (plain radiographs to exclude bony injury), preoperative assessment and consent, operative repair of one or more extensor tendons under regional or general anesthesia, intraoperative irrigation and debridement as needed, layered closure and splinting, and postoperative hand therapy with serial follow-up for tenorrhaphy healing and range-of-motion restoration. Typical documentation includes operative note with tendon(s) repaired, approach, anesthesia, laterality, complications, and any concurrent procedures (eg, debridement, nerve repair). Typical demographic: adults with traumatic injuries to forearm/wrist extensor tendons, often from lacerations, crush injuries, or delayed presentation after initial wound care.
Coding Specifications
| Modifier | Description | When to Use |
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LT / |