Summary & Overview
CPT 26455: Open Tenotomy of Flexor Tendon of Finger
CPT code 26455 denotes an open tenotomy of a finger flexor tendon — a focused hand surgery procedure used to release pathologic tendon tightness or prepare the digit for further reconstructive work. Nationally, this code matters for surgical care pathways, resource planning for ambulatory and inpatient hand surgery services, and accurate procedural reporting for payment and quality measurement. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find concise clinical context about the procedure, common settings where it is performed, and the types of benchmarking and policy-relevant topics typically associated with procedural CPT codes: utilization trends, site-of-service considerations, and coding nuances that affect claims processing. The summary highlights payer coverage considerations and outlines the benchmarks and policy updates that influence reimbursement and administrative workflows for hand and upper-extremity surgical services. Data not available in the input for specific payor policies, modifiers usage frequency, associated taxonomies, and ICD-10 diagnosis pairings.
Billing Code Overview
CPT code 26455 describes an open tenotomy of a flexor tendon of a finger, a surgical procedure that involves the deliberate division of a flexor tendon to address tendon tightness, contracture, or to facilitate subsequent reconstructive procedures. This procedure is typically categorized as hand surgery and falls under the broader service type of operative musculoskeletal procedures.
- Typical site of service: ambulatory surgical center or hospital operating room
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old manual laborer presenting with progressive flexion contracture and pain of the ring finger due to a chronic flexor tendon entrapment or a previous laceration with adhesions. Conservative care (splinting, therapy, corticosteroid injection if indicated) failed to restore full passive and active extension. After clinical exam and imaging confirm restricted tendon gliding or a tendon scar/adhesion, the patient is scheduled for an open flexor tenotomy under regional block or general anesthesia in an ambulatory surgical center or hospital outpatient setting. The procedure involves a small open incision over the affected tendon sheath, identification of the fibrotic segment or adherent portion of the flexor tendon, and controlled surgical division of the tendon to relieve contracture and improve finger alignment and function. Postoperative workflow includes wound care, hand therapy to optimize range of motion, pain management, and follow-up visit for suture removal and functional assessment. Typical documentation includes indication, tendon(s) treated, laterality, anesthesia type, intraoperative findings, estimated blood loss, complications, and postoperative plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | When no additional modifier applies and reporting the procedure as usual |