2025 CPT code 26352
(Active) Effective Date: N/A Surgery - Musculoskeletal System Feed
Secondary repair or advancement of a flexor tendon in the hand or finger (excluding zone 2) using a free graft.
Modifiers may be applicable to this code depending on the specific circumstances of the procedure. For instance, modifier "-54" is used if the surgeon performs only the surgical portion of the procedure. Other modifiers like 76, 77, 78, 79 may apply if subsequent, repeat, or related procedures are performed.
Medical necessity must be documented and justified by the treating physician. It should detail the functional impairment caused by the initial tendon injury, failure of the primary repair (if applicable), and the need for a secondary procedure with a free graft to restore function. The medical record should also explain why a less invasive procedure is not a viable option.
The surgeon is responsible for performing the procedure, including obtaining the free graft, repairing or advancing the tendon, and managing postoperative care. They must accurately document the procedure, including location, size of the graft, and any complications.
In simple words: This procedure repairs a tendon in your hand or finger that helps you bend it. It's done when the first repair didn't work or there's not enough tissue. The surgeon takes a piece of tissue from somewhere else in your body to help fix the tendon.This is not done in a specific area of the finger called "zone 2".
Repair or advancement of flexor tendon, not in zone 2 digital flexor tendon sheath (e.g., no man's land); secondary with free graft (includes obtaining graft), each tendon. This procedure involves the repair or advancement of a flexor tendon in the hand or finger, excluding zone 2. It is considered a secondary repair and utilizes a free graft, which is obtained during the procedure.The procedure is performed when the primary repair has failed, or the injury requires additional tissue for reconstruction. Zone 2 refers to the area of the flexor tendon sheath in the finger known as "no man's land."
Example 1: A patient previously underwent flexor tendon repair in their thumb.Due to complications, the tendon did not heal correctly. Now, several months later, they undergo a secondary repair using a free graft from the wrist to reconstruct the damaged tendon., A patient sustained a deep laceration to their palm, injuring a flexor tendon outside of zone 2. Due to tissue loss, a primary repair was insufficient. A secondary procedure is performed using a free graft from the foot to bridge the gap and restore tendon function., A patient's finger was crushed in an accident, severely damaging the flexor tendon. After initial debridement and stabilization, they require a secondary procedure with a free graft to reconstruct the tendon and restore finger movement.
Documentation should include the location of the tendon injury, the type of graft used, the method of repair or advancement, operative details, and any complications encountered.Prior records of the initial injury and treatment should also be available.
** This code is reported per tendon.If multiple tendons are repaired or advanced, it should be reported with the appropriate number of units. Be sure to check with payers for their specific coverage policies.
- Global Days : The global period is usually 90 days; this includes all necessary postoperative care.
- Payment Status: Active
- Modifier TC rule: Modifier TC is not applicable to this code, as it is a surgical procedure involving the harvesting of a free graft. Modifier 54 may be appropriate when the surgeon only perform surgical portion.
- Fee Schedule : Historical fee schedule information can be obtained from CMS or other relevant resources.
- Specialties:Hand Surgery, Orthopedic Surgery, Plastic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient