2025 CPT code 26357
(Active) Effective Date: N/A Revision Date: N/A Surgery - Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers Musculoskeletal System Feed
Secondary repair of a single digital flexor tendon in zone 2 (no man's land) without a free graft; each tendon.
Modifiers 59 (distinct procedural service), 76 (repeat procedure by the same physician), LT (left side), and RT (right side) and finger modifiers (F1-F9, FA) may be applicable depending on the circumstances of the procedure. Consult your payer's guidelines.
Medical necessity is established by documentation of a symptomatic flexor tendon laceration in zone 2 that impairs finger function.The secondary repair is medically necessary to restore function and prevent long-term complications such as contractures or stiffness. Documentation should clearly outline the failure of conservative treatments (if attempted) and the need for surgical intervention.
The surgeon's responsibilities include prepping and anesthetizing the patient, making the incision, accessing and repairing the lacerated flexor tendon(s) using appropriate sutures, controlling bleeding, and closing the wound in layers.The surgeon must ensure proper asepsis and hemostasis.
In simple words: This code describes a surgical procedure to fix a torn tendon in a finger, specifically in a hard-to-reach area of the palm. This is done more than a week after the initial injury and does not use a transplanted piece of tissue from another area of the body.The doctor repairs the tendon to restore movement and function in the finger.
This CPT code, 26357, denotes the surgical repair or advancement of a single flexor tendon located in zone 2 of the digital flexor tendon sheath (often referred to as "no man's land").This procedure is specifically for secondary repairs performed more than seven days post-injury and does not involve the use of a free graft.The repair may involve suturing the tendon ends or other techniques to restore tendon integrity and function. Each tendon repaired requires a separate code.
Example 1: A patient presents with a 10-day-old flexor tendon laceration in the ring finger (zone 2) following a knife injury.The surgeon performs a secondary repair of the flexor tendon using 26357. No free graft is used., A patient presents with a lacerated flexor tendon in the middle finger (zone 2) sustained two weeks prior.The deep flexor tendon is intact.The surgeon performs a secondary repair using 26357.The patient had previous treatment elsewhere., A patient sustained a complex hand injury three weeks ago and underwent initial treatment elsewhere. The surgeon performs a secondary repair of multiple flexor tendons in zone 2 in the index and middle fingers with use of 26357 for each tendon. Modifier 59 is used to indicate that these are distinct procedural services.
Detailed operative report specifying the location and extent of the laceration, the specific tendon(s) repaired, the surgical technique used, and the type of suture material. Preoperative and postoperative photographs, as well as any relevant imaging studies (X-rays, MRI) are required to support medical necessity.Documentation of the previous treatment elsewhere is important if applicable.
** Accurate coding requires precise documentation of the specific tendon(s) involved, the surgical technique used, and the reason for the secondary repair.Pay close attention to the definition of zone 2 and the exclusion of free graft use.Ensure that proper modifiers are used when appropriate and that all documentation supports medical necessity for the procedure.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- RVU: This information is not available in the provided text.Consult the AMA CPT codebook or your payer's fee schedule for the most up-to-date RVU values.
- Global Days : The global period is not specified in the provided text. The global period for surgical procedures varies depending on the specific procedure and payer policies.Consult your payer's guidelines.
- Payment Status: Active
- Modifier TC rule: This code does not typically involve a technical component (TC) modifier.The entire procedure is usually performed by the surgeon.
- Fee Schedule : Fee schedules are payer-specific and change frequently.Consult your payer's fee schedule for the most current information. Historical fee data is not available from the source.
- Specialties:Orthopedic Surgery, Hand Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)