Summary & Overview
CPT 25280: Tendon Length Adjustment/Repair, Forearm or Wrist
CPT code 25280 covers surgical adjustment of tendon length in the forearm or wrist to repair injury-related damage. This code identifies a specific tendon-lengthening or repair procedure used to restore functional alignment and relieve abnormal tension after trauma. Nationally, accurate coding for tendon repair procedures affects surgical case mix reporting, reimbursement, and quality measurement for upper-extremity trauma care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the range of payers relevant to coverage and billing. The publication summarizes common billing considerations, typical modifier usage where available, and high-level benchmarking and reimbursement themes for CPT code 25280.
This analysis provides clinicians, billing professionals, and policy analysts with an overview of the code’s clinical purpose, payer landscape, and the types of benchmarks and policy updates that influence payment and documentation practices. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25280 describes a surgical procedure in which the provider adjusts the length of a tendon in the forearm or wrist to repair damage resulting from injury. This procedure is a tendon lengthening/repair technique performed to restore function, relieve tension, or correct deformity caused by traumatic injury to forearm or wrist tendons.
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Service type: Surgical tendon repair/length adjustment
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Typical site of service: Operating room or ambulatory surgical center, with procedure focused on the forearm or wrist
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-handed construction worker presents to the orthopedic hand clinic after a laceration to the volar forearm sustained by broken glass three weeks earlier. He reports persistent weakness in wrist flexion and difficulty with fine hand motions despite initial wound care and rehabilitation. Physical exam demonstrates a shortened, adherent flexor tendon with limited excursion and a palpable scar at the wrist crease. Imaging and clinical assessment indicate tendon shortening requiring surgical lengthening to restore function.
The clinical workflow includes preoperative evaluation by the hand surgeon, informed consent, baseline neurovascular and tendon function documentation, and scheduling for operative tendon lengthening under regional or general anesthesia. Intraoperative steps typically include exposure of the affected tendon, assessment of tendon quality and degree of contracture, performance of a tendon lengthening (e.g., Z-plasty or fractional lengthening) to restore appropriate tension and excursion, and repair or reinforcement as needed. Postoperative care includes splinting, pain control, early supervised therapy, and follow-up visits for wound and functional assessment. Billing uses 25280 for the tendon lengthening procedure on a forearm or wrist tendon.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure |