Summary & Overview
CPT 25290: Open Flexor Tendon Release, Forearm or Wrist
CPT code 25290 denotes an open surgical incision of a flexor tendon in the forearm or wrist to release a contracted tendon, reduce pressure on a joint, and restore range of motion. This procedure is clinically significant for patients with tendon contractures that impair hand and wrist function and may affect functional independence and quality of life. Nationally, 25290 is relevant across surgical, orthopedic, and hand specialty practices and impacts facility and surgeon billing for operative hand procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is used in clinical practice, typical sites of service, and the service classification. The publication also provides benchmarking context where available, summaries of relevant billing considerations, and clinical context that clarifies when this open tendon-release procedure is coded. Data not available in the input is identified explicitly where applicable.
Billing Code Overview
CPT code 25290 describes an open surgical procedure in which the provider incises a flexor tendon in the forearm or wrist to release a contracted tendon, relieve pressure on an affected joint, and restore range of motion. This procedure is performed to address tendon contractures that limit hand and wrist function.
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Service type: Open surgical tendon release (flexor tendon incision)
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Typical site of service: Hospital operating room or ambulatory surgical center for hand/wrist surgery
Clinical & Coding Specifications
Clinical Context
A 58-year-old right-hand-dominant patient presents to the orthopedic clinic with progressive pain, palpable cording, and limited flexion of the ring and small fingers of the dominant hand over several months. Physical examination demonstrates a flexion contracture at the proximal interphalangeal joint and a thickened, palpable flexor tendon sheath in the distal forearm/wrist region with diminished active finger extension and decreased grip function. Nonoperative treatments (splinting, activity modification, and corticosteroid injection) provided inadequate relief. The patient is scheduled for an open surgical release of the contracted flexor tendon in the wrist/forearm under regional block with monitored anesthesia care in an ambulatory surgery center. The clinical workflow includes preoperative evaluation, informed consent, marking of the operative extremity, administration of regional anesthesia, an open incision over the affected flexor tendon, careful dissection to release the constricting tissue, restoration of tendon glide, intraoperative assessment of range of motion, layered closure, and postoperative hand therapy instructions and follow-up for wound check and rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for the procedure due to extensive scar tissue or markedly complex release. |