CPT 26496: Opponensplasty, Tendon Transfer to Restore Thumb Opposition

Medicare pays $904 on average nationally for this procedure.

CPT code 26496 describes an opponensplasty, a surgical tendon transfer procedure performed to restore thumb opposition (the ability of the thumb to move across the palm and oppose the fingertips). The service is an operative hand surgery typically performed in an ambulatory surgical center or hospital operating room and involves mobilization and transfer of a donor tendon to reestablish thumb function for activities requiring grasp and pinch.

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Clinical & Coding Specifications

Clinical Context

A typical patient presenting for 26496 is an adult with significant loss of thumb opposition following traumatic median nerve injury, long-standing thenar muscle atrophy, or sequelae of severe peripheral neuropathy. The patient often reports inability to oppose the thumb to the fingertips, difficulty with key pinch and grasp, and impaired activities of daily living such as buttoning, writing, or manipulating small objects. Prior to surgery, the patient undergoes history, focused hand and wrist physical examination, and imaging as indicated (plain radiographs to assess joint alignment; ultrasound or MRI selectively to evaluate tendon integrity). Nonoperative measures include hand therapy, splinting, and attempted nerve repair if acute; when function does not recover or tendon transfer is indicated, opponensplasty (26496) is scheduled.

Typical workflow on the day of service: preoperative consent and marking, regional or general anesthesia, surgical exposure of donor tendon (commonly the flexor digitorum superficialis of the ring finger or the palmaris longus when available), harvest and rerouting of the tendon through soft-tissue tunnels to the thenar region, tensioning and fixation to recreate thumb opposition, layered closure, sterile dressing and postoperative immobilization in a thumb spica splint. The patient is discharged to home with specific hand therapy and follow-up for suture removal and progressive mobilization.

Typical site of service is an ambulatory surgery center or hospital outpatient surgery department. The service type is a reconstructive hand surgery (operative tendon transfer) performed by a hand or orthopedic/plastic surgeon with hand surgery expertise.

A realistic patient scenario: a 45-year-old right-hand‑dominant construction worker with chronic median nerve injury after forearm laceration 8 months prior, persistent thenar atrophy, absent opposition, and failure of reinnervation after conservative management. The surgeon plans an opponensplasty (26496) using ring finger flexor digitorum superficialis transfer to restore thumb opposition, performed under regional block in the ambulatory surgery center with planned postoperative hand therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`26055`	Tenolysis, flexor tendon; single finger	May be performed if adhesions of donor tendon require release prior to or during opponensplasty.
`26440`	Transfer or transposition of tendon, flexor or extensor, forearm and/or wrist area	Related tendon transfer techniques in the forearm/wrist region that may be performed as alternatives or adjuncts.
`26580`	Reconstruction, extensor tendon, thumb (includes transposition or tendon graft)	Performed for extensor deficits of the thumb that may be addressed in the same operative setting when multiple tendon repairs are required.
`64721`	Neuroplasty and/or transposition; median nerve at carpal tunnel	Carpal tunnel release or median nerve decompression/repair may be performed prior to or concurrently when nerve pathology contributes to loss of opposition.

Related Modifiers

12 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
81	Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…	- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

Showing 1–10 of 12

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208U00000X	Clinical Pharmacology Physician	Clinical pharmacology encompasses the spectrum of activities related to the discovery, development, regulation, and utilization of safe and effective …
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
207W00000X	Ophthalmology Physician	An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207YP0228X	Pediatric Otolaryngology Physician	A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired condi…
171400000X	Health & Wellness Coach	The Health & Wellness Coach is trained in motivational theories, strategies, and communication techniques, which are used to assist patients to develo…
320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intelle…

Related ICD-10-CM Codes

19 rows

ICD-10-CM Code	Description
G56.01	Carpal tunnel syndrome, right upper limb
G56.02	Carpal tunnel syndrome, left upper limb
M05.841	Other rheumatoid arthritis with rheumatoid factor of right hand
M05.842	Other rheumatoid arthritis with rheumatoid factor of left hand
M06.041	Rheumatoid arthritis without rheumatoid factor, right hand
M06.042	Rheumatoid arthritis without rheumatoid factor, left hand
M08.051	Unspecified juvenile rheumatoid arthritis, right hip
M08.052	Unspecified juvenile rheumatoid arthritis, left hip
M19.041	Primary osteoarthritis, right hand
M19.042	Primary osteoarthritis, left hand

Showing 1–10 of 19

Related Payer Policy Updates

Specialty: Orthopedics/Musculoskeletal1 / 2

7 rows

Policy	Payer	Effective Date
Hip Arthroplasty (partial and total hip replacement)	univerahealthcare	2026-10-15
Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)	univerahealthcare	2026-10-15
Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)	univerahealthcare	2026-10-15
Metal-on-Metal Total Hip Resurfacing	univerahealthcare	2026-10-15
Lumbar Fusion (arthrodesis) with decompression	univerahealthcare	2026-10-15
Osteochondral Grafting of the Knee	univerahealthcare	2026-10-15
Sacroiliac Joint Fusion or Stabilization	univerahealthcare	2026-10-15

CPT 26340: Manipulation of Finger Joint Under Anesthesia

CPT-26341-POST-ENZYME-MANIPULATION-FINGER-DUPUYTRENS

CPT 26341: Manual Finger Manipulation After Enzyme Injection

CPT-26350-FLEXOR-TENDON-REPAIR-HAND-FINGER-NOT-ZONE-2

CPT 26350: Flexor Tendon Repair/Advancement (Hand/Finger, Not Zone 2)

CPT-26352-FLEXOR-TENDON-REPAIR-FREE-GRAFT-DELAYED-RECONSTRUCTION

CPT 26352: Flexor Tendon Repair/Advancement with Free Graft (Non–Zone 2)

CPT-26356-FLEXOR-TENDON-REPAIR-FINGER

CPT 26356: Flexor Tendon Repair of Finger

CPT-26357-DELAYED-FLEXOR-TENDON-REPAIR-FINGER

CPT 26357: Delayed Repair of Flexor Tendon in Finger

CPT-26358-FLEXOR-TENDON-REPAIR-WITH-FREE-GRAFT

CPT 26358: Flexor Tendon Repair of Finger with Free Graft

CPT-26370-PRIMARY-PROFUNDUS-TENDON-REPAIR-FINGER

CPT 26370: Primary Repair of Flexor Digitorum Profundus Tendon in Finger

CPT-26372-SECONDARY-REPAIR-PROFUNDUS-TENDON-FREE-GRAFT-FINGER

CPT 26372: Secondary Flexor Profundus Tendon Repair with Free Graft

CPT-26373-SECONDARY-REPAIR-PROFUNDUS-TENDON-FINGER-PRESERVE-SUPERFICIALIS

CPT 26373: Secondary Repair of Flexor Profundus Tendon in Finger

Showing 1–10 of 84

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`26055`	Tenolysis, flexor tendon; single finger	May be performed if adhesions of donor tendon require release prior to or during opponensplasty.
`26440`	Transfer or transposition of tendon, flexor or extensor, forearm and/or wrist area	Related tendon transfer techniques in the forearm/wrist region that may be performed as alternatives or adjuncts.
`26580`	Reconstruction, extensor tendon, thumb (includes transposition or tendon graft)	Performed for extensor deficits of the thumb that may be addressed in the same operative setting when multiple tendon repairs are required.
`64721`	Neuroplasty and/or transposition; median nerve at carpal tunnel	Carpal tunnel release or median nerve decompression/repair may be performed prior to or concurrently when nerve pathology contributes to loss of opposition.

Related Modifiers

12 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
81	Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…	- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

Showing 1–10 of 12

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208U00000X	Clinical Pharmacology Physician	Clinical pharmacology encompasses the spectrum of activities related to the discovery, development, regulation, and utilization of safe and effective …
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
207W00000X	Ophthalmology Physician	An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207YP0228X	Pediatric Otolaryngology Physician	A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired condi…
171400000X	Health & Wellness Coach	The Health & Wellness Coach is trained in motivational theories, strategies, and communication techniques, which are used to assist patients to develo…
320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intelle…

Related ICD-10-CM Codes

19 rows

ICD-10-CM Code	Description
G56.01	Carpal tunnel syndrome, right upper limb
G56.02	Carpal tunnel syndrome, left upper limb
M05.841	Other rheumatoid arthritis with rheumatoid factor of right hand
M05.842	Other rheumatoid arthritis with rheumatoid factor of left hand
M06.041	Rheumatoid arthritis without rheumatoid factor, right hand
M06.042	Rheumatoid arthritis without rheumatoid factor, left hand
M08.051	Unspecified juvenile rheumatoid arthritis, right hip
M08.052	Unspecified juvenile rheumatoid arthritis, left hip
M19.041	Primary osteoarthritis, right hand
M19.042	Primary osteoarthritis, left hand

Showing 1–10 of 19

Related Payer Policy Updates

Specialty: Orthopedics/Musculoskeletal1 / 2

7 rows

Policy	Payer	Effective Date
Hip Arthroplasty (partial and total hip replacement)	univerahealthcare	2026-10-15
Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)	univerahealthcare	2026-10-15
Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)	univerahealthcare	2026-10-15
Metal-on-Metal Total Hip Resurfacing	univerahealthcare	2026-10-15
Lumbar Fusion (arthrodesis) with decompression	univerahealthcare	2026-10-15
Osteochondral Grafting of the Knee	univerahealthcare	2026-10-15
Sacroiliac Joint Fusion or Stabilization	univerahealthcare	2026-10-15

CPT 26340: Manipulation of Finger Joint Under Anesthesia

CPT-26341-POST-ENZYME-MANIPULATION-FINGER-DUPUYTRENS

CPT 26341: Manual Finger Manipulation After Enzyme Injection

CPT-26350-FLEXOR-TENDON-REPAIR-HAND-FINGER-NOT-ZONE-2

CPT 26350: Flexor Tendon Repair/Advancement (Hand/Finger, Not Zone 2)

CPT-26352-FLEXOR-TENDON-REPAIR-FREE-GRAFT-DELAYED-RECONSTRUCTION

CPT 26352: Flexor Tendon Repair/Advancement with Free Graft (Non–Zone 2)

CPT-26356-FLEXOR-TENDON-REPAIR-FINGER

CPT 26356: Flexor Tendon Repair of Finger

CPT-26357-DELAYED-FLEXOR-TENDON-REPAIR-FINGER

CPT 26357: Delayed Repair of Flexor Tendon in Finger

CPT-26358-FLEXOR-TENDON-REPAIR-WITH-FREE-GRAFT

CPT 26358: Flexor Tendon Repair of Finger with Free Graft

CPT-26370-PRIMARY-PROFUNDUS-TENDON-REPAIR-FINGER

CPT 26370: Primary Repair of Flexor Digitorum Profundus Tendon in Finger

CPT-26372-SECONDARY-REPAIR-PROFUNDUS-TENDON-FREE-GRAFT-FINGER

CPT 26372: Secondary Flexor Profundus Tendon Repair with Free Graft

CPT-26373-SECONDARY-REPAIR-PROFUNDUS-TENDON-FINGER-PRESERVE-SUPERFICIALIS

CPT 26373: Secondary Repair of Flexor Profundus Tendon in Finger

Showing 1–10 of 84

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

CPT 26496: Opponensplasty, Tendon Transfer to Restore Thumb Opposition

Sign up for cpt 26496 policy alerts

CPT 26496: Opponensplasty, Tendon Transfer to Restore Thumb Opposition

Sign up for cpt 26496 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 26496: Opponensplasty, Tendon Transfer to Restore Thumb Opposition

Sign up for cpt 26496 policy alerts

CPT 26496: Opponensplasty, Tendon Transfer to Restore Thumb Opposition

Sign up for cpt 26496 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 26496 (opponensplasty) describe and where is it typically performed?

What clinical situations commonly lead to performing an opponensplasty (26496)?

What is the typical operative workflow and immediate postoperative care for 26496?

Which related CPT codes might be billed alongside or in relation to 26496?

What ICD‑10 diagnoses in the page content are associated with indications for opponensplasty (26496)?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 26496 (opponensplasty) describe and where is it typically performed?

What clinical situations commonly lead to performing an opponensplasty (26496)?

What is the typical operative workflow and immediate postoperative care for 26496?

Which related CPT codes might be billed alongside or in relation to 26496?

What ICD‑10 diagnoses in the page content are associated with indications for opponensplasty (26496)?

References