Summary & Overview
CPT 26390: Flexor Tendon Synthetic Rod Implant
CPT code 26390 identifies a surgical implant procedure in which a synthetic rod is placed in the flexor tendon sheath of a finger or hand to facilitate subsequent tendon graft harvesting. The code is reported once per rod implant and applies to procedures performed in operative settings, typically ambulatory surgical centers and hospital operating rooms. Nationally, this code is relevant to hand surgeons, orthopedic and plastic surgery practices, and facilities managing reconstructive tendon repair pathways. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical intent of the code, common sites of service, and which major payers commonly adjudicate claims for this service. The publication presents benchmarks and policy context relevant to reimbursement and billing practice, outlines typical service-line considerations for surgical hand procedures, and flags areas where claims documentation and coding specificity affect payment. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 26390 describes a surgical procedure in which the provider makes an incision over a flexor tendon in a patient’s finger or hand to place a synthetic rod intended to occupy the tendon sheath for later tendon graft harvesting. This is a surgical implant procedure performed on the fingers or hand.
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Service type: Surgical implant preparation for future tendon grafting
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with chronic flexor tendon scarring in the finger after a previous laceration and repair, resulting in loss of tendon glide and severe functional limitation. The hand surgeon plans a two-stage flexor tendon reconstruction: first-stage placement of a silicone tendon rod to create a pseudotendon sheath and maintain tendon length, allowing finger mobilization while soft tissues recover; second-stage tendon grafting will occur later when the bed is suitable. The procedure involves a focused incision over the affected flexor tendon sheath in the finger/hand, blunt dissection to the flexor sheath, insertion and placement of a synthetic rod (reported once per rod with 26390), closure of skin, and application of a dorsal blocking splint. Typical workflow includes preoperative evaluation in the clinic, informed consent, preoperative anesthesia evaluation, procedure in an ambulatory surgery center or hospital outpatient department under regional block or general anesthesia, postoperative hand therapy planning, and scheduled second-stage tendon grafting once the rod has established a gliding surface.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When the rod is implanted in a right finger/hand |