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    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Hand and FingersCPT cpt-26358-flexor-tendon-repair-with-free-graft
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    CPT 26358: Flexor Tendon Repair of Finger with Free Graft

    Medicare pays $953 on average nationally for this procedure.

    CPT code 26358 describes surgical repair of an injured flexor tendon of a finger with incorporation of a free graft to complete the repair; the procedure is aimed at restoring digital flexion function and relieving pain. Service type: operative tendon repair with grafting. Typical site of service: ambulatory surgical center or hospital operating room for hand surgery performed by an orthopedic or hand surgeon.

    For related coverage guidance, see recent payer policy updates: Implants for Joint Pain, Bone Lengthening (Distraction Osteogenesis), Orthopedic Applications of Stem Cell Therapy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old right-hand–dominant male presents to the emergency department after a workplace accident with a deep laceration to the volar aspect of the ring finger. Examination reveals loss of active flexion at the proximal interphalangeal joint and a visibly disrupted flexor digitorum superficialis tendon. Imaging rules out fracture. The hand surgeon evaluates the wound in the ED, documents tendon involvement and neurovascular status, and schedules operative repair with a free tendon graft due to segmental tendon loss. The operative workflow includes preoperative consent, regional block or general anesthesia, surgical exploration of the flexor sheath, debridement of scarred/contaminated tissue, harvest of an autologous tendon graft (commonly palmaris longus or toe extensor), interposition grafting and primary repair to re-establish tendon continuity, pulleys and sheath repair as indicated, layered closure, and a postoperative immobilization and hand therapy plan to restore function and prevent adhesion formation. Inpatient or outpatient postoperative follow-up includes wound checks, suture removal, and staged hand therapy with early controlled motion protocols when permitted.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    26055Repair, flexor tendon, with free tendon graft (includes harvesting) — fingerA closely related code; may represent more limited grafting or different anatomic level and should be selected per operative details and CPT definitions.
    26160Tenolysis, flexor tendon, fingerPerformed postoperatively if adhesions limit tendon glide following primary repair and grafting.
    11042Debridement; skin, subcutaneous tissue and muscle, first 20 sq cm or lessUsed when extensive debridement of contaminated tissue is required prior to tendon repair (select appropriate debridement codes by depth and area).
    29827Arthroscopy, wrist, surgical; with therapeutic procedures (Note: wrist arthroscopy code example)May be performed adjunctively if concomitant wrist pathology requires arthroscopic intervention (used only when clinically indicated).
    29075Application of long arm or long leg cast (Note: example immobilization code)Used for postoperative immobilization of the forearm/hand when casting is required as part of postoperative care.

    Related Modifiers

    14 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

    Showing 1–10 of 14

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207W00000X
    363L00000X
    364SS0200X
    1041C0700X
    2251C2600X
    2084V0102X
    207XS0114X

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Implants for Joint PainBlue Cross Blue Shield - Rhode Island2027-03-01
    Bone Lengthening (Distraction Osteogenesis)regence2027-01-01
    Orthopedic Applications of Stem Cell TherapyBlue Cross Blue Shield - Rhode Island2027-01-01
    Bone Lengthening (Distraction Osteogenesis)Blue Cross Blue Shield - North Dakota2027-01-01
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Sacroiliac Joint Fusion for the Treatment of Adult Low-Back Pain Medical PolicyHealth-New-England2026-12-01
    Bone Grafts and Stabilization Devices for Spinal Defects - Medical PolicyHealth-New-England2026-12-01
    Implantable Shock Absorbers for Treatment of Knee Osteoarthritisblue cross blue shield - louisiana2026-12-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06

    Related Codes

    CPT-26340-FINGER-JOINT-MANIPULATION-UNDER-ANESTHESIA

    CPT 26340: Manipulation of Finger Joint Under Anesthesia

    CPT-26341-POST-ENZYME-MANIPULATION-FINGER-DUPUYTRENS

    CPT 26341: Manual Finger Manipulation After Enzyme Injection

    CPT-26350-FLEXOR-TENDON-REPAIR-HAND-FINGER-NOT-ZONE-2

    CPT 26350: Flexor Tendon Repair/Advancement (Hand/Finger, Not Zone 2)

    CPT-26352-FLEXOR-TENDON-REPAIR-FREE-GRAFT-DELAYED-RECONSTRUCTION

    CPT 26352: Flexor Tendon Repair/Advancement with Free Graft (Non–Zone 2)

    CPT-26356-FLEXOR-TENDON-REPAIR-FINGER

    CPT 26356: Flexor Tendon Repair of Finger

    CPT-26357-DELAYED-FLEXOR-TENDON-REPAIR-FINGER

    CPT 26357: Delayed Repair of Flexor Tendon in Finger

    CPT-26370-PRIMARY-PROFUNDUS-TENDON-REPAIR-FINGER

    CPT 26370: Primary Repair of Flexor Digitorum Profundus Tendon in Finger

    CPT-26372-SECONDARY-REPAIR-PROFUNDUS-TENDON-FREE-GRAFT-FINGER

    CPT 26372: Secondary Flexor Profundus Tendon Repair with Free Graft

    CPT-26373-SECONDARY-REPAIR-PROFUNDUS-TENDON-FINGER-PRESERVE-SUPERFICIALIS

    CPT 26373: Secondary Repair of Flexor Profundus Tendon in Finger

    CPT-26390-FLEXOR-TENDON-SYNTHETIC-ROD-IMPLANT

    CPT 26390: Implantation of Synthetic Flexor Tendon Rod

    Showing 1–10 of 84

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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