Summary & Overview
CPT 26483: Tendon Transfer/Transplant in Carpometacarpal/Dorsal Hand
CPT code 26483 denotes a tendon transfer or tendon transplant with graft in the carpometacarpal area or dorsal hand. This microsurgical procedure restores tendon function at the junction between the wrist’s carpal bones and the bases of the metacarpals and is relevant for reconstructive hand surgery, traumatic tendon loss, and certain chronic tendon disorders. Nationally, accurate coding of such reconstructive procedures matters for surgical quality tracking, appropriate payment, and clinical outcome attribution.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides clinicians, coding professionals, and policy analysts with benchmarks and contextual guidance on clinical indications, expected sites of service (hospital outpatient, ambulatory surgery center, or inpatient OR), and common billing considerations tied to tendon transfer/transplant services. It highlights typical use cases of CPT code 26483, summarizes payer coverage patterns where available, and explains how the code fits within surgical hand reconstruction practice. Data not available in the input is identified where applicable. Readers will gain a concise clinical and billing overview, comparison-ready language for payer conversations, and a foundation for further claim-level or policy-specific review.
Billing Code Overview
CPT code 26483 describes a surgical procedure in which a provider transfers or transplants a tendon in the carpometacarpal region or dorsum (back) of the hand using a tendon graft. The procedure addresses tendon dysfunction or loss by relocating or reconstructing tendon continuity at the carpometacarpal articulations—the junction where the wrist’s carpal bones meet the bases of the five metacarpal bones of the hand.
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Service type: Tendon transfer or tendon transplant with graft in the carpometacarpal/dorsal hand region
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient operating room depending on clinical complexity and patient factors
Clinical & Coding Specifications
Clinical Context
A 45-year-old right-hand–dominant patient presents with chronic dysfunction of the thumb carpometacarpal region following traumatic injury and failed conservative management. The patient reports pain, instability, and loss of pinch strength. Imaging demonstrates tendon injury with tendon discontinuity and scar tethering at the carpometacarpal/back of hand region. The surgical plan is tendon transfer with use of a tendon graft to restore tendon continuity and hand function.
Preoperative workflow: history and physical, informed consent, baseline hand function and neurovascular exam, imaging (X-ray and/or ultrasound, MRI as indicated), pre-anesthesia evaluation, and verification of laterality. Intraoperative workflow: general or regional anesthesia, sterile preparation of the hand and forearm, harvest of tendon graft (autograft or allograft), release of scar tissue, transfer or transposition of a viable donor tendon into the carpometacarpal/back-of-hand target, tensioning and fixation of the graft, layered closure, and application of sterile dressing and immobilization. Postoperative workflow: immediate PACU monitoring, pain management, immobilization in a cast or splint, early hand therapy per surgeon protocol, wound checks, and staged rehabilitation to restore range of motion, strength, and function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right hand. |