Summary & Overview
CPT 26180: Finger Flexor or Extensor Tendon Excision
CPT code 26180 denotes surgical excision of a flexor or extensor tendon of the finger and is used once per tendon removed. This code matters nationally because finger tendon procedures affect functional outcomes for a broad patient population and intersect with surgical, rehabilitation, and device services. Payers commonly encounter claims for this code across commercial and public programs, making consistent coding and clinical documentation important for accurate reimbursement and care coordination.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, how the service line typically presents in ambulatory surgery centers and hospital outpatient departments, and a concise review of common billing considerations.
This publication provides benchmarks and operational guidance relevant to billing teams and revenue cycle staff: typical sites of service and the single-use-per-tendon reporting rule, common modifiers for procedural circumstances (listed separately), and where to look for related coding guidance. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 26180 describes the excision (removal) of a flexor or extensor tendon of the finger. This procedure is performed to restore or improve the finger’s ability to bend and straighten by removing the affected tendon tissue. Use of this code is recorded once for each tendon excised.
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Service type: Surgical procedure, tendon excision of the finger
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Typical site of service: Ambulatory surgery center or hospital outpatient surgical department; may also be performed in an office-based surgical setting depending on clinical and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 42-year-old right-handed carpentry technician presents with progressive pain, triggering, and loss of smooth flexion of the right index finger after a laceration several months earlier. Examination shows a palpable nodule along the flexor tendon sheath and reduced digit range of motion. Conservative care including splinting and corticosteroid injection provided partial, temporary relief. The surgeon elects to perform excision of the diseased portion of the flexor tendon to remove scarred or adherent tendon tissue and restore tendon gliding.
The clinical workflow begins with preoperative evaluation in the hand surgery clinic, informed consent, and documentation of laterality and level (digit and specific tendon). The procedure is performed in an ambulatory surgery center or hospital outpatient department under regional block or general anesthesia. Intraoperatively, the provider identifies the affected flexor tendon, excises the pathologic segment or tenolysis as indicated, achieves hemostasis, and closes the wound. Postoperative care includes wound care instructions, pain management, and early supervised therapy with a hand therapist to optimize tendon glide and function. Billing uses 26180 once per tendon excised; laterality and number of tendons are clearly documented in the operative report.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |