Summary & Overview
CPT 26356: Repair of Flexor Tendon of Finger
CPT code 26356 designates surgical repair of a flexor tendon injury in a finger, a procedure aimed at restoring range of motion and alleviating pain after tendon laceration or trauma. Nationally, this code is relevant to orthopedic and hand surgeons, surgical facilities, and payers managing post-injury surgical care and rehabilitation. It is used to document operative management of finger flexor tendon injuries and supports billing for the surgical service and facility resources required.
Key payers discussed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find comparative benchmarks and coverage considerations across major national payers, clinical context for when the procedure is typically performed, and operational details such as common sites of service. The publication outlines typical utilization patterns, coding considerations tied to operative repair of finger flexor tendons, and informs administrative and clinical stakeholders about payment and policy themes affecting this procedure. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 26356 describes surgical repair of an injury to a finger flexor tendon, such as a laceration, performed to restore tendon function and relieve pain. This procedure involves direct repair of a damaged flexor tendon in one of the fingers.
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Service type: Surgical tendon repair
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 32-year-old right-hand–dominant construction worker presents to the emergency department after a work-related laceration to the volar aspect of the ring finger. Physical exam demonstrates an open wound with inability to actively flex the distal interphalangeal joint, suggesting a flexor digitorum profundus tendon laceration. Neurovascular status is intact. Radiographs show no fracture. The patient is counseled and scheduled for operative primary repair of the flexor tendon under regional block in an ambulatory surgical center.
The clinical workflow includes preoperative evaluation (history, tetanus status, consent), operative repair of the injured flexor tendon (26356) under sterile conditions with appropriate anesthesia, intraoperative documentation of tendon ends, suture technique, and any core/epitendinous repairs. Postoperative plan includes immobilization in a dorsal blocking splint, referral to hand therapy for early controlled mobilization protocols, wound care instructions, pain control, and scheduled follow-up visits for suture removal and rehabilitation monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the repaired finger is on the left hand |