CPT 26357: Delayed Flexor Tendon Repair of Finger
CPT code 26357 denotes a delayed repair of a flexor tendon in a finger performed more than seven days after injury. Nationally, this code captures a specific hand surgery service that addresses functional restoration and pain relief for patients presenting beyond the acute window. Accurate reporting of this procedure is important for surgical case-mix, quality measurement, and appropriate payment for operative hand care.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for delayed flexor tendon repair, practical guidance on where the service is typically performed, and a summary of the payer landscape included in the analysis. The publication highlights benchmarks and policy updates relevant to coding and coverage for operative hand procedures, as well as clinical considerations that affect billing and utilization.
The content is intended for coding professionals, surgical providers, revenue cycle staff, and policy analysts seeking a clear, national-level summary of CPT code 26357, its clinical purpose, and the payer scope covered in the accompanying analysis.
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Billing Code Overview
CPT code 26357 describes a surgical repair of a flexor tendon injury in a finger performed more than seven days after the initial injury. The procedure restores tendon function and relieves pain following a delayed presentation or when initial management was deferred.
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Service type: Delayed flexor tendon repair of a finger
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Typical site of service: Outpatient surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand dominant construction worker presents to the hand surgery clinic 10 days after sustaining a deep laceration to the volar aspect of the ring finger from a circular saw. Initial first-aid and wound cleaning were performed in the emergency department; imaging excluded foreign body and fracture. The patient has decreased active flexion at the proximal interphalangeal joint and pain with passive stretch, consistent with a flexor tendon injury. The hand surgeon schedules operative repair of the flexor digitorum profundus tendon more than seven days after the injury, citing the delayed presentation and need for meticulous dissection and possible tenolysis. The procedure is performed in an ambulatory surgery center under regional block with intraoperative nerve monitoring as needed. Postoperative care includes immobilization in a dorsal blocking splint, supervised occupational therapy for protected passive and active motion protocols, and follow-up visits to assess wound healing and tendon glide.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the repair requires substantially greater work than typical (extensive dissection, scar tissue release). |
52 | Reduced services | Use when the full procedure is not completed or is intentionally reduced. |
57 | Description | Data not available in the input. |
59 | Distinct procedural service | Use to indicate a separate procedure or distinct operative site when another unrelated procedure is performed on the same date. |
62 | Two surgeons | Use when a second surgeon with a different specialty performs distinct portions of the repair. |
66 | Surgical team (e.g., cardiac surgery) | Use when a coordinated surgical team performs portions of the procedure requiring multiple surgeons. |
79 | Description | Data not available in the input. |
80 | Assistant surgeon | Use when a surgical assistant (e.g., another surgeon) assists and payer requires reporting. |
81 | Minimum assistant surgeon | Use when a minimal assistant role is documented and payable by some payers. |
82 | Assistant (when qualified resident not available) | Use when an assistant surgeon is used instead of a qualified resident. |
LT | Left side | Use to identify the left finger when laterality is required by payer. |
RT | Right side | Use to identify the right finger when laterality is required by payer. |
TC | Technical component | Use when only the facility/technical component of the service is billed (rare for surgical CPT codes). |
26 | Professional component | Use to report the professional (surgeon) component when split billing applies. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207T00000X | Orthopedic Hand Surgery | Common specialty for complex flexor tendon repairs. |
207K00000X | Orthopedic Surgery | General orthopedists frequently perform hand tendon repairs. |
2080P0006X | Plastic Surgery | Plastic surgeons with hand fellowship perform tendon reconstruction. |
261QE0200X | Occupational Therapy | Postoperative therapy providers manage rehabilitation protocols. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
26055 | Repair, tendon, primary or secondary, flexor, without free graft; single finger | Performed for acute primary flexor tendon repair when within primary repair window; may be performed at earlier presentation instead of delayed repair. |
26356 | Repair, flexor tendon of finger, delayed; primary repair, single tendon | Per CPT sequencing, closely related code for delayed repairs—26357 denotes repair more than seven days following injury for certain circumstances. |
26010 | Repair, tendon sheath, e.g., tenolysis; single tendon | May be used when tenolysis or release of adhesions is needed during delayed repair. |
26418 | Repair, tendon extensor or insertion, finger | Used when concomitant extensor tendon procedures are required or evaluated in the same operative setting. |
11042 | Debridement; skin, subcutaneous tissue and muscle (one or more) | May be reported when significant debridement is required prior to tendon repair in contaminated or heavily scarred wounds. |