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2025 CPT code 26489

Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon.

This code is reported once for each tendon transferred with a free tendon graft.

Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (modifier 22) or multiple procedures (modifier 51).

Medical necessity is established by documenting the functional impairment caused by the damaged or non-functional tendon and how the tendon transfer will improve the patient's condition. This often includes descriptions of limitations in daily activities, range of motion loss, or loss of hand strength.

The surgeon is responsible for all aspects of the procedure, from patient preparation and anesthesia to incision, graft harvesting, tendon transfer, suturing, and wound closure.

In simple words: The surgeon moves a tendon in your palm to fix a damaged or non-functional tendon. They use a piece of tendon from elsewhere in your body as a graft to help connect and secure the transferred tendon.

This procedure involves transplanting a tendon in the palmar area of the hand using a free tendon graft. After preparing and anesthetizing the patient, the surgeon makes an incision to expose the tendon. A graft is obtained, often from the palmaris longus or plantaris tendon, and attached to the target tendon. The tendon with the graft is moved and sutured into place, aiming to restore lost function due to paralysis or injury.

Example 1: A patient with ulnar nerve palsy requires transfer of a functioning tendon to restore lost finger extension., A patient with a severed tendon in the palm requires a tendon transplant with a graft to repair the damaged tendon and regain function., A patient with median nerve palsy needs a tendon transfer with a graft to restore thumb opposition, utilizing a free tendon graft for additional length and stability.

Documentation should include the reason for the transfer (e.g., paralysis, injury), the specific tendons involved, the source of the graft, the surgical technique used, and any complications encountered.

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