CPT 26460 Open Extensor Tenotomy Reimbursement | OpenPayer

Summary & Overview

CPT 26460: Open Extensor Tenotomy of Hand or Finger

CPT code 26460 denotes an open tenotomy—surgical division of an extensor tendon of the hand or finger. This operative code is nationally relevant because it captures a common hand surgery intervention used to correct extensor tendon dysfunctions that impair finger extension and hand function. Proper coding affects clinical reporting, utilization tracking, and facility planning for ambulatory surgery and inpatient services. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical overview, payer coverage context, typical sites of service, and related billing considerations. The publication outlines benchmark considerations for utilization and reimbursement patterns, highlights relevant policy and coding updates where applicable, and situates the procedure within routine hand surgery workflows. The content is intended for health policy analysts, revenue cycle managers, and clinicians involved in procedural documentation and billing, offering a clear reference for how CPT code 26460 is used in national billing practice. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 26460hand surgerytenotomyextensor tendonambulatory surgerysurgical procedureprocedure codingrevenue cycle

Billing Code Overview

CPT code 26460 describes an open tenotomy, the surgical division of an extensor tendon of the hand or finger. The procedure involves a provider making an incision to release or divide an extensor tendon to address conditions such as tendon contracture, triggering, or deformity affecting finger or hand extension.

Service type: Surgical procedure (open tendon surgery)
Typical site of service: Ambulatory surgery center or hospital operating room for hand surgery

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45-year-old right-hand-dominant manual worker who presents with persistent dorsal finger pain, visible tendon imbalance, and decreased active extension of the proximal interphalangeal joint after a zone II extensor tendon scar contracture from prior injury. Conservative care including splinting and therapy has failed to restore function. The hand surgeon evaluates range of motion, tendon continuity, and tendon excursion, documents failed nonoperative management, obtains informed consent, and schedules an outpatient open tenotomy of the involved extensor tendon. The procedure is performed in an ambulatory surgery center or hospital outpatient department under regional block or local anesthesia with sedation. Postoperative workflow includes wound care instructions, a brief observation period, analgesia management, and early hand therapy or splinting as indicated for finger mobilization and to prevent recurrence of adhesions and contracture.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the surgeon's professional service separate from facility technical component if applicable.
`50`	Bilateral procedure

CPT 26370: Primary Repair of Profundus Tendon in Finger

CPT-26428-CENTRAL-SLIP-REPAIR-BOUTONNIERE-DEFORMITY

CPT 26428: Central Slip Repair for Boutonniere Deformity

CPT-26426-CENTRAL-SLIP-REPAIR-BOUTONNIERE-DEFORMITY

CPT 26426: Central Slip Repair for Boutonniere Deformity

CPT-26477-EXTENSOR-TENDON-SHORTENING-HAND-FINGER

CPT 26477: Extensor Tendon Shortening of Hand or Finger

CPT-26567-FINGER-PHALANX-PARTIAL-EXCISION

CPT 26567: Partial Excision of Finger Phalanx

CPT-26536-INTERPHALANGEAL-JOINT-RECONSTRUCTION-REPLACEMENT

CPT 26536: Interphalangeal Joint Reconstruction or Replacement

CPT-26518-HAND-JOINT-STABILIZATION-THREE-FOUR-DIGITS

CPT 26518: Stabilization of Metacarpophalangeal/Proximal Interphalangeal Joints

CPT-26450-OPEN-FLEXOR-TENOTOMY-PALM

CPT 26450: Open Tenotomy of Flexor Tendon, Palm

CPT-26561-SYNDACTYLY-RELEASE-SEPARATION-OF-JOINED-FINGERS

CPT 26561: Surgical Separation of Congenitally Joined Fingers

CPT-26502-TENDON-PULLEY-RECONSTRUCTION

CPT 26502: Tendon Pulley Reconstruction with Graft

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Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopedic Surgery	Most common specialty performing hand extensor tendon procedures.
`207XS0101X`	Plastic Surgery	Hand and microsurgery specialists performing tendon releases and reconstructions.
`2080P0207X`	General Surgery - Hand Surgery	Surgeons with hand-focused practice performing tenotomy procedures.
`261QM0800X`	Physical Medicine & Rehabilitation	Often provides pre- and postoperative hand therapy coordination (nonoperative management oversight).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M24.331`	Contracture, right hand	Extensor tenotomy may be performed to release a limiting contracture affecting finger extension.
`M24.332`	Contracture, left hand	Same clinical relevance for the left hand.
`S66.131A`	Strain of extensor muscle or tendon of right forearm, initial encounter	Acute or chronic extensor tendon injury that may lead to surgical tenotomy if conservative care fails.
`S66.132A`	Strain of extensor muscle or tendon of left forearm, initial encounter	Left-sided equivalent contributing to need for surgical release.
`M67.821`	Other tenosynovitis, right hand	Chronic tenosynovitis with tendon constriction or deformity sometimes treated with tenotomy when release is required.
`M67.822`	Other tenosynovitis, left hand	Left-sided equivalent.
`M20.41`	Hallux valgus (acquired), right foot	Data not applicable anatomically; included to indicate no relevance — however this row would not typically be used for hand tenotomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`26055`	Repair, flexor tendon, primary or secondary; digit, single	Performed when flexor tendon injury is present on the same digit and may be done concurrently or in staged repair.
`26120`	Tenolysis, flexor tendon; finger	Tenolysis may be performed for adhesions when motion is restricted; extensor tenotomy can be an alternative or adjunct.
`26418`	Repair, extensor tendon, primary or secondary; finger	Direct extensor tendon repair is related when tendon continuity is restored rather than released; may be performed in same setting if indicated.
`25920`	Arthroplasty/release, tendon sheath (trigger finger)	Often performed for concomitant pulley release or trigger digit pathology affecting tendon gliding.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa	Local steroid injection or diagnostic aspiration may precede or accompany nonoperative management prior to surgery.

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