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Official Description

Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26392 involves the removal of a synthetic rod and the insertion of a flexor tendon graft in the hand or finger. This procedure is typically indicated when a flexor tendon repair has either failed or was not performed in a timely manner, necessitating a two-stage approach to tendon repair. The first stage, represented by CPT® Code 26390, involves the initial excision of the injured tendon and the placement of a synthetic rod to facilitate healing. The synthetic rod serves as a temporary support structure, allowing the tendon sheath to heal around it over a period of approximately 10 weeks. In the second stage, which is captured by CPT® Code 26392, a tendon graft is harvested from either the forearm or leg. The procedure requires reopening the original incision to attach the graft to the synthetic rod, which is then removed, allowing the graft to be pulled into the newly formed tendon sheath. This meticulous process ensures that the graft is properly positioned and secured, ultimately restoring function and range of motion to the affected hand or finger.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 26392 is indicated for the following conditions:

  • Failed Flexor Tendon Repair The procedure is performed when a previous flexor tendon repair has not succeeded, necessitating further intervention to restore function.
  • Delayed Flexor Tendon Grafting This procedure is indicated when a flexor tendon repair is not performed in a timely manner, requiring a two-stage approach to ensure proper healing and functionality.

2. Procedure

The procedure for CPT® Code 26392 involves several critical steps to ensure successful tendon grafting:

  • Harvesting the Tendon Graft A tendon graft is harvested from the forearm or leg, which will be used to replace the damaged flexor tendon. This step is crucial as it provides the necessary biological material for the repair.
  • Opening the Incision The distal and proximal ends of the old incision are reopened to access the area where the synthetic rod is located. This allows for the proper attachment of the tendon graft to the synthetic rod.
  • Attaching the Tendon Graft The harvested tendon graft is then attached to the proximal end of the synthetic rod. This connection is essential for the subsequent removal of the rod and the positioning of the graft within the tendon sheath.
  • Removing the Synthetic Rod The synthetic rod is carefully removed through the distal end of the old incision. As the rod is withdrawn, the tendon graft is simultaneously pulled into the newly formed tendon sheath, ensuring that it is properly positioned.
  • Suturing the Tendon Graft Once the tendon graft is in place, it is sutured to the proximal end of the native tendon. This step is vital for securing the graft and restoring continuity to the tendon structure.
  • Adjusting Tension The tension of the tendon graft is adjusted to achieve the desired range of motion. Proper tension is critical for optimal function and recovery of the hand or finger.
  • Anchoring the Graft Finally, the distal end of the tendon graft is trimmed and anchored to the bone, ensuring stability and support for the newly repaired tendon.

3. Post-Procedure

Post-procedure care following the tendon grafting involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised to limit movement of the affected hand or finger to allow the graft to integrate effectively. Rehabilitation and physical therapy may be recommended to restore function and strength as healing progresses. The overall recovery timeline can vary based on individual circumstances and the extent of the initial injury.

Short Descr REPAIR/GRAFT HAND TENDON
Medium Descr RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
Long Descr Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 2
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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