Summary & Overview
CPT 26450: Open Tenotomy of Flexor Tendon, Palm
CPT code 26450 denotes an open tenotomy of a flexor tendon in the palm, a targeted operative intervention to release constricted tendons and improve hand function. Nationally, this code matters for surgical orthopedics and hand surgery billing because it captures a distinct procedural service with implications for operative scheduling, surgical setting choice, and specialty coding workflows. Typical settings include hospital operating rooms and ambulatory surgery centers where minor to moderate hand surgeries are performed.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, standard sites of service, and the common modifiers associated with reporting this service. The publication outlines expected billing considerations, coding specificity for an open flexor tendon release, and how the procedure is categorized across payers.
This overview helps clinicians, coding staff, and billing professionals understand what CPT code 26450 represents, which settings commonly deliver the service, and which major national payers are relevant for coverage and claims processing. Data not available in the input for elements such as associated taxonomies, specific ICD-10 diagnosis pairings, and payer-specific reimbursement benchmarks is noted where applicable.
Billing Code Overview
CPT code 26450 describes an open tenotomy, a surgical procedure involving the division of a flexor tendon of the palm. This procedure is performed to release a tight or constricted flexor tendon and restore hand function.
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Service type: Surgical procedure — open tendon release
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Typical site of service: Operating room, ambulatory surgery center, or other licensed surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with symptomatic flexor tendon contracture or triggering of a finger (eg, trigger finger) causing pain, reduced flexion, and functional impairment. The patient often has a history of progressive catching, locking, or a fixed flexion deformity of a finger despite conservative treatment such as splinting, corticosteroid injection, and activity modification. Preoperative evaluation includes history, focused hand and tendon exam, assessment of neurovascular status, and imaging only if needed. The procedure 26450 (open tenotomy of a flexor tendon of the palm) is performed in an outpatient ambulatory surgery center or hospital outpatient department under regional block, local with sedation, or general anesthesia. The surgeon makes a palmar incision at the site of the tendon constriction, exposes the flexor tendon sheath or adhesions, and divides the tendon or releasing structures to restore glide and finger extension. Typical intraoperative documentation includes indication, informed consent, anesthesia type, procedure performed, laterality, estimated blood loss, complications (if any), and dressing. Postoperative workflow includes short recovery monitoring, instructions for wound care, pain control, hand therapy referral for range-of-motion and tendon gliding exercises, and follow-up within 1–2 weeks for wound check and suture removal. Billing uses 26450 for the open surgical division of a flexor tendon in the palm; laterality modifiers LT or RT may be appended, and global period and postoperative therapy needs are documented per payer policies.
Coding Specifications
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