Summary & Overview
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.
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.
-
Service type: Surgical tendon repair (primary flexor tendon repair)
-
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). |