Summary & Overview
CPT 26170: Excision of Flexor or Extensor Tendon, Palm of Hand
CPT code 26170 designates the surgical excision of a flexor or extensor tendon in the palm of the hand, reported once per tendon removed. This code captures a focused, functional hand surgery aimed at restoring grasp or correcting deforming motion and is relevant across ambulatory surgery centers, hospital outpatient departments, and inpatient operating rooms. Nationally, accurate use of this code affects surgical quality measurement, claims adjudication, and resource allocation for hand surgical services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and an outline of common modifiers used with this service. The publication also provides benchmarking and coverage considerations where available, payer-specific billing nuances, and coding reminders to ensure the code is reported per tendon excised. The goal is to help billing professionals, coding auditors, and clinical managers understand when CPT code 26170 applies, how it fits into surgical service lines, and what elements commonly affect claim processing and reimbursement. Data not available in the input will be noted explicitly where relevant.
Billing Code Overview
CPT code 26170 describes the surgical excision (removal) of a flexor or extensor tendon of the palm of the hand. The procedure is performed to restore or improve hand grasping motion or to correct movement that controls opening of the hand. Use of this code is reported once for each tendon excised.
Service type: Surgical procedure — tendon excision/tenotomy of the hand
Typical site of service: Operating room or outpatient surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old manual laborer presenting with progressive loss of active flexion or extension of one finger and pain from a chronically scarred or ruptured tendon in the palmar hand. Conservative measures including splinting and hand therapy have failed to restore functional grasp. Examination shows tendon discontinuity or tethering with impaired digit motion and palpable nodule or scar in the palmar aspect. Imaging (ultrasound or MRI) confirms tendon pathology isolated to a single flexor or extensor tendon.
The clinical workflow: preoperative evaluation by the hand surgeon includes history, physical exam, and imaging; informed consent emphasizing risks and benefits; pre-op medical clearance if indicated; procedural scheduling in an ambulatory surgery center or hospital operating room under regional block or general anesthesia; surgical excision of the diseased tendon segment with exploration of adjacent structures; wound closure and dressing; immediate post-operative pain control and immobilization; referral to hand therapy for range-of-motion and strengthening once healing permits; routine follow-up visits to monitor wound, function, and complications such as infection or stiffness.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to excise the tendon is substantially greater than typical (extensive scar tissue, revision surgery). |