Summary & Overview
CPT 26416: Extensor Tendon Graft Replacement, Hand/Finger
CPT code 26416 denotes a hand surgery procedure in which a previously implanted synthetic rod is removed and replaced with an extensor tendon graft at the same operative session. This reconstructive step is typically performed after staged reconstruction using a silicone or synthetic spacer to create a suitable bed for tendon grafting. The code is reported once per rod removed and replaced, making accurate reporting important for procedure counts and resource tracking. Key payers in national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing overview of the procedure, guidance on typical sites of service, and what to expect in terms of procedural reporting (one unit per rod replaced). The summary also highlights where to look for related surgical codes and clinical context when billing for staged tendon reconstruction of the hand and fingers. Data not available in the input for payer-specific rates, ICD-10 pairings, taxonomies, and related codes.
Billing Code Overview
CPT code 26416 describes a surgical procedure in which the provider incises the skin over a previously placed synthetic rod in a patient’s finger or hand to create a site for an extensor tendon graft, removes that synthetic rod, and replaces it with an extensor tendon graft. This code is reported once for each rod removed and replaced with a tendon graft.
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Service type: Surgical tendon reconstruction/replacement involving removal of an implanted spacer and immediate grafting
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Typical site of service: Ambulatory surgical center or hospital operating room for hand and finger surgery
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents for the second stage of a staged extensor tendon reconstruction of the finger. At the initial stage, the surgeon implanted a silicone/synthetic rod to create a pseudosheath and maintain alignment after extensor tendon injury with adhesions and loss of tendon continuity. During this outpatient procedure, the provider makes a skin incision directly over the synthetic rod, dissects to the rod, removes the previously placed rod, and inserts an autologous or allograft extensor tendon graft to restore finger extension. Typical workflow includes preoperative evaluation and consent, regional or local anesthesia in an ambulatory surgery center or hospital outpatient department, intraoperative irrigation and hemostasis, tendon graft placement and fixation, layered closure, and simple postoperative immobilization and hand therapy referral. This code is reported once for each rod removed and replaced with a tendon graft and is commonly performed by hand surgeons or orthopedic surgeons with hand specialization in an ambulatory surgery center or hospital outpatient setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no special circumstances apply. |
11 |