CPT 26370: Primary Repair of Profundus Tendon in Finger
CPT code 26370 denotes primary surgical repair of the flexor digitorum profundus tendon in the finger with preservation of the flexor digitorum superficialis. This procedure is commonly performed within days of a laceration or traumatic avulsion to restore active flexion and reduce long-term functional impairment. Nationally, accurate coding of tendon repair procedures affects surgical quality measurement, post-operative care authorization, and reimbursement consistency across payers.
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 the operational implications for billing and documentation. The publication also provides benchmark considerations and notes on common coding scenarios relevant to surgical hand specialists, orthopedics, and plastic surgery practices.
This summary prepares clinicians, coding professionals, and policy analysts to interpret CPT code 26370 for administrative and clinical workflows, with attention to coding accuracy, timely surgical intervention, and common payer coverage patterns. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 26370 describes a surgical procedure to perform a primary repair of the flexor digitorum profundus (profundus) tendon in the finger while preserving the flexor digitorum superficialis (superficialis) tendon. The procedure is typically performed within a few days of injury to restore tendon continuity and finger flexion.
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Service type: Surgical tendon repair (primary flexor tendon repair)
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Typical site of service: Ambulatory surgical center or hospital operating room for hand surgery or microsurgical procedures
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28-year-old right-hand–dominant construction worker who presents to the emergency department within 48 hours after a laceration to the volar surface of the ring finger from broken glass. The patient reports inability to actively flex the distal interphalangeal (DIP) joint. Physical exam shows an open zone I/II flexor tendon injury with intact flexor digitorum superficialis (FDS) function and suspected flexor digitorum profundus (FDP) transection. Sensation and perfusion to the fingertip are intact. The hand surgeon evaluates the patient in the ED, documents mechanism, neurovascular status, tendon gap, and timing since injury, orders tetanus update and perioperative antibiotics as indicated, and schedules operative primary repair of the profundus tendon within a few days.
Operative workflow includes regional block or general anesthesia, sterile prep, exploration through a volar digital incision, preservation of the superficialis tendon, identification of the FDP ends, debridement, and primary end-to-end repair of the profundus tendon (zone I/II) using core and epitendinous sutures. Postoperative care involves hand immobilization in a dorsal blocking splint, early hand therapy per surgeon protocol, and scheduled follow-up visits for wound check and progressive range-of-motion therapy to minimize adhesions and optimize finger function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician’s professional component for services with a separate technical component (rare for this procedure). |
50 | Bilateral procedure | When the same profundus tendon repair is performed on corresponding fingers of both hands during the same operative session. |
51 | Multiple procedures | When this repair is performed in the same operative session with other distinct procedures on the same claim. |
52 | Reduced services | When the procedure is partially reduced or not completed as described. |
53 | Discontinued procedure | When the procedure is started but terminated due to extenuating circumstances. |
59 | Distinct procedural service | When reporting a separate, distinct procedure (e.g., separate incision or non-overlapping surgical site) on the same day. |
62 | Two surgeons | When two surgeons work together as primary surgeons performing distinct portions of the repair. |
66 | Surgical team | When a surgical team performs complex reconstruction involving this repair. |
78 | Return to OR for related procedure during global period | When the patient returns to the operating room for a complication related to the original repair during the global period. |
79 | Unrelated procedure or service by the same physician during the postoperative period | When an unrelated procedure is performed by the same physician during the global period. |
LT | Left side | To identify the left finger involved. |
RT | Right side | To identify the right finger involved. |
QK | Surgical first assistant | When a credentialed first assistant is reported with the service (facility-dependent). |
QX | Assistant-at-surgery (physician assistant) | When a qualified physician assistant provides assistant-at-surgery services according to scope-of-practice. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopedic Hand Surgery | Orthopedic surgeons with hand subspecialty frequently perform flexor tendon repairs. |
| 207P00000X | Plastic Surgery Hand | Plastic surgeons specializing in hand surgery perform primary tendon repairs and reconstruction. |
| 208000000X | General Orthopedic Surgery | General orthopedists who manage hand trauma may perform this procedure. |
| 2086S0123X | Occupational/Hand Therapy | Hand therapists are not procedure performers but provide essential postoperative rehabilitation; included for clinical team context. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S66.421A | Complete traumatic rupture of flexor tendon of right little finger at forearm level, initial encounter | Represents an acute flexor tendon rupture requiring primary repair when occurring within days of injury. |
S66.422A | Complete traumatic rupture of flexor tendon of left little finger at forearm level, initial encounter | Left-sided equivalent; used when injury is to the left finger and repaired primarily. |
S66.031A | Complete traumatic rupture of flexor tendon of right index finger at finger level, initial encounter | Finger-level FDP transections commonly treated with primary repair. |
S66.032A | Complete traumatic rupture of flexor tendon of left index finger at finger level, initial encounter | Left index finger FDP rupture—clinical indication for repair. |
S64.431A | Traumatic rupture of flexor digitorum profundus tendon of right middle finger, initial encounter | Specifically identifies FDP injury of the middle finger, directly relevant to 26370. |
S64.432A | Traumatic rupture of flexor digitorum profundus tendon of left middle finger, initial encounter | Left-sided FDP rupture code for primary repair. |
T79.A1XA | Traumatic compartment syndrome of right upper limb, initial encounter | Possible associated complication in severe soft-tissue injuries; may alter surgical planning and postoperative monitoring. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
26055 | Tenolysis, flexor tendon; single finger | May be performed later if adhesions limit tendon glide after primary repair and therapy. |
26160 | Tenolysis, flexor tendon, each tendon | Alternate code for tenolysis when addressing individual tendon adhesions in the finger. |
29305 | Application of short arm splint; with or without casting | Common immediate postoperative immobilization applied after tendon repair. |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., wrist) | May be reported if a separate diagnostic or therapeutic joint injection is required in the perioperative period (rare). |
26010 | Excision, lesion of flexor tendon sheath (e.g., trigger finger) | Performed if concomitant tendon sheath pathology is addressed during the operative session. |