Summary & Overview
CPT 26510: Tendon Transfer for Ulnar Drift Correction
CPT code 26510 represents a reconstructive hand surgery procedure: tendon transfer to correct ulnar drift of the fingers, commonly performed for deformities caused by rheumatoid arthritis and other conditions that disrupt tendon balance. Nationally, this code is relevant to orthopedic and hand surgery practices, ambulatory surgery centers, and hospital outpatient departments because it defines billing for corrective tendon procedures that restore function and alignment of the digits.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and the billing landscape associated with hand reconstructive surgery. The publication provides benchmarks and payment considerations, common modifier usage (listed separately), and policy implications affecting coverage and preauthorization for reconstructive tendon procedures. Additionally, the resource outlines documentation elements payers commonly require for medical necessity and details where to find related coding guidance.
This national summary is intended for coding professionals, surgical practices, and policy analysts seeking a concise explanation of CPT code 26510, its clinical purpose, and the payer environment that governs reimbursement for ulnar drift corrective tendon transfers.
Billing Code Overview
CPT code 26510 describes a surgical tendon transfer performed to correct ulnar drift, a deformity in which the fingers and hand deviate toward the small-finger (ulnar) side. The procedure involves transferring a tendon from one side of a finger to the other to realign fingers and restore more balanced digital positioning.
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Service type: Surgical tendon transfer for correction of finger deviation (reconstructive hand surgery)
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Typical site of service: Ambulatory surgical center or hospital operating room for hand surgery
Clinical & Coding Specifications
Clinical Context
A 62-year-old woman with long-standing seropositive rheumatoid arthritis presents with progressive ulnar drift of the fingers of her dominant right hand, causing impaired grip, pain, and difficulty performing activities of daily living such as buttoning and holding utensils. After failed conservative management including splinting, occupational therapy, and disease-modifying antirheumatic drug optimization, the hand surgeon elects to perform a tendon transfer to centralize extensor tendons and correct ulnar deviation of the fingers.
The clinical workflow includes preoperative evaluation with focused hand examination and radiographs to assess joint alignment, informed consent documenting risks/benefits, preoperative anesthesia assessment (regional block or general anesthesia), operative tendon transfer of affected digits (one or more fingers) with soft-tissue balancing, and immediate postoperative immobilization in a protective splint. Follow-up includes wound checks, suture removal, and staged occupational therapy for edema control, range of motion, and tendon glide restoration over 6–12 weeks. Documentation should capture laterality, number of digits treated, complexity, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Applied when the procedure is performed on the left hand |