Summary & Overview
CPT 26392: Removal of Synthetic Rod and Flexor Tendon Graft Replacement
CPT code 26392 denotes the removal of a previously implanted synthetic rod from the finger or hand and replacement with an autologous flexor tendon graft. Procedures like this are central to restoring hand and finger function after prior reconstructive work and matter nationally because they impact functional outcomes, surgical resource use, and postoperative rehabilitation needs across diverse payer populations. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what CPT code 26392 represents clinically, where it is typically performed (ambulatory surgery centers and hospital surgical units), and how it is reported (once per rod removed). The publication provides clinical context for the procedure, outlines typical service settings, and summarizes common modifiers associated with reporting. Where available, the analysis highlights benchmark payment considerations and documentation priorities that affect coding and billing workflows. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 26392 describes a surgical procedure in which the provider removes a previously implanted synthetic rod from a patient’s finger or hand and replaces it with a harvested flexor tendon graft to create or restore a tendon gliding site. The procedure involves incising the skin over the synthetic rod, extracting the rod, and placing a flexor tendon graft harvested from the patient into the created site.
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Service type: Surgical tendon reconstruction/replacement
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Typical site of service: Operative setting such as an ambulatory surgery center or hospital outpatient/inpatient surgical unit
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who previously underwent staged flexor tendon reconstruction using a silicone rod implanted along the flexor sheath of a finger to create a gliding tunnel. After an interval allowing soft-tissue lining to form around the rod and recovery from prior surgery, the patient returns for definitive tendon grafting. In the operating room under regional block or general anesthesia, the surgeon incises the skin over the synthetic rod, dissects to the rod, removes it, prepares and harvests an autologous tendon graft (commonly palmaris longus or a slip of flexor digitorum superficialis), threads the graft through the formed sheath, and secures it proximally and distally to restore flexor tendon continuity. Typical workflow includes preoperative marking and consent, anesthesia induction, sterile prep, incision and rod removal, tendon harvest and grafting, wound closure, sterile dressing, and postoperative hand therapy referral. Typical site of service is an ambulatory surgery center or hospital outpatient surgical department. The procedure is reported once for each rod removed when multiple digits are treated in separate sites.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when a separate incisional event for rod removal/tendon graft is not described by another more specific modifier and services are distinct from other procedures on the same day. |