Summary & Overview
CPT 25310: Tendon Transfer, Forearm/Wrist to Restore Hand Motion
CPT code 25310 denotes a surgical tendon transfer in the forearm or wrist performed to replace a damaged or diseased tendon and restore hand motion. This reconstructive procedure is clinically important for restoring function after tendon rupture, severe laceration, or progressive tendon disease, and it has implications for surgical resource use, rehabilitation needs, and postoperative care coordination nationally. Key payers commonly covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 25310 applies, typical sites of service, and which payer programs are most relevant. The publication also outlines what to expect in benchmarking and billing practice content: common reimbursement considerations, coding nuances, and clinical factors that influence utilization and authorization. Where input data is missing, the report indicates that specific items are not available in the input. This overview is designed for health plan analysts, surgical billing teams, and clinicians seeking a national perspective on the code’s clinical role and administrative implications.
Billing Code Overview
CPT code 25310 describes a tendon transfer in the forearm or wrist where a provider transfers a functioning tendon from one location to another to replace a damaged or diseased tendon and restore hand motion. This procedure is a surgical reconstructive service intended to improve hand function when native tendons are nonfunctional.
Service type: Tendon transfer / reconstructive hand surgery
Typical site of service: Hospital operating room or ambulatory surgical center, with care and occasional follow-up provided in outpatient surgical clinics.
Clinical & Coding Specifications
Clinical Context
A 45-year-old right-handed construction worker presents with loss of finger flexion after a zone II flexor tendon rupture in the dominant hand caused by a laceration 6 months prior. Conservative repair attempts and rehabilitation failed due to tendon scarring and loss of glide. The hand surgeon evaluates persistent inability to actively flex the finger despite intact muscle function proximally and identifies a nonfunctional distal tendon segment. The surgeon plans a tendon transfer in the forearm to substitute a damaged flexor tendon and restore active digit motion.
Preoperative workflow includes history and physical focused on hand and wrist function, comparative neurovascular exam, imaging as indicated (radiographs, ultrasound), informed consent, and documentation of failed prior repair or irreparable tendon injury. The procedure is performed in an operating room or ambulatory surgery center under regional or general anesthesia with sterile technique. Intraoperative steps include exposure of donor and recipient tendons in the forearm/wrist, mobilization of the donor tendon, tensioning and fixation of the transferred tendon to the recipient to restore functional range of motion, and layered closure. Postoperative workflow includes immobilization in a splint, early supervised hand therapy protocol per surgeon preference, wound checks, and progressive strengthening to optimize transfer function and motion restoration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct Procedural Service |