Summary & Overview
CPT 26445: Tenolysis of Extensor Tendon, Hand or Finger
CPT code 26445 denotes tenolysis of an extensor tendon in the hand or finger, a surgical intervention to release adhesions that restrict tendon motion. This procedure is clinically important because hand and finger tendon adhesions can cause significant functional impairment and loss of hand dexterity; tenolysis aims to restore tendon glide and improve outcomes for activities of daily living. Nationally, the code is relevant to surgical specialties including hand surgery, orthopedics, and plastic surgery, and to payers managing surgical episode costs and post-operative rehabilitation needs.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service, common settings where the service is delivered, and the payer landscape covered. The publication provides benchmarks and policy context such as utilization patterns, coding considerations, and reimbursement framing across major commercial payers and Medicare. It also outlines clinical context relevant to preoperative indications and the role of tenolysis in restoring function following tendon injury or unsuccessful primary repair. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 26445 describes tenolysis of the extensor tendon of the hand or finger, a surgical procedure to release the tendon from adhesions and restore gliding function. The procedure involves identifying and freeing the extensor tendon where scar tissue or adhesions limit motion.
Service type: Surgical procedure — tendon release/repair of the hand or finger
Typical site of service: Hospital outpatient department, ambulatory surgery center, or hospital inpatient depending on clinical complexity and anesthesia needs
Clinical & Coding Specifications
Clinical Context
A 48-year-old right-hand dominant office worker presents with persistent loss of active finger extension and pain after open reduction and internal fixation of a distal radius fracture 9 months earlier. Conservative management including hand therapy and serial splinting failed to restore tendon glide. The orthopedic hand surgeon schedules surgical tenolysis of the extensor tendon to release adhesions and restore independent extension of the affected finger.
Preoperative workflow includes evaluation in the office with documentation of decreased active range of motion compared to passive range, imaging to rule out hardware impingement, preoperative clearance as indicated, and informed consent noting risks and expected outcomes. The procedure is performed in an outpatient ambulatory surgery center or hospital same-day surgery unit under regional block or monitored anesthesia care. Postoperative care includes hand therapy beginning within days, wound checks, and scheduled follow-up to document improvement in tendon glide and active motion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and complexity substantially exceed typical tenolysis due to extensive scar tissue or additional releases documented. |