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Official Description

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

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26416 involves the removal of a synthetic rod and the insertion of an extensor tendon graft in the hand or finger. This procedure is typically indicated when an extensor tendon repair has either failed or was not performed in a timely manner, necessitating a two-stage surgical approach to restore function. The first stage, which is coded under CPT® Code 26415, involves the excision of the injured tendon and the placement of a synthetic rod to facilitate healing. The second stage, represented by CPT® Code 26416, focuses on the actual grafting process. During this stage, a tendon graft is harvested from either the forearm or leg, and the previously placed synthetic rod is removed. As the rod is extracted, the tendon graft is pulled into the newly formed tendon sheath, allowing for proper alignment and attachment to the native tendon. This procedure is critical for patients who have experienced tendon injuries that require surgical intervention to restore hand or finger function.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure coded as CPT® 26416 is indicated for patients who have experienced a failure of extensor tendon repair or have not undergone timely repair of the extensor tendon. This situation may arise due to various factors, including trauma, chronic conditions, or complications from previous surgical interventions. The need for a two-stage procedure is essential to ensure proper healing and restoration of function in the hand or finger.

  • Failure of extensor tendon repair The procedure is indicated when a previous repair has not successfully restored tendon function.
  • Delayed extensor tendon repair This procedure is necessary when the repair has not been performed within an appropriate timeframe, leading to complications.

2. Procedure

The procedure involves several critical steps to ensure successful tendon grafting. Each step is designed to facilitate the removal of the synthetic rod and the insertion of the tendon graft.

  • Step 1: Harvesting the tendon graft A tendon graft is obtained from the forearm or leg, which will be used to replace the damaged extensor tendon. This step is crucial as it provides the necessary biological material for the grafting process.
  • Step 2: Opening the incision The distal and proximal ends of the previous incision are reopened to access the site where the synthetic rod is located. This allows for the removal of the rod and the insertion of the graft.
  • Step 3: Attaching the tendon graft The harvested tendon graft is attached to the proximal end of the synthetic rod. This connection is vital for the subsequent removal of the rod and the placement of the graft into the tendon sheath.
  • Step 4: Removing the synthetic rod The synthetic rod is carefully removed through the distal end of the incision. As the rod is extracted, the tendon graft is simultaneously pulled into the newly formed tendon sheath, ensuring proper placement.
  • Step 5: Suturing the tendon graft Once the tendon graft is in position, it is sutured to the proximal end of the native tendon. This step is essential for securing the graft and restoring continuity to the tendon structure.
  • Step 6: 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.
  • Step 7: Anchoring the graft The distal end of the tendon graft is trimmed and anchored to the bone, ensuring stability and support for the healing process.

3. Post-Procedure

After the completion of the procedure, patients can expect a recovery period that may involve immobilization of the hand or finger to allow for proper healing of the tendon graft. Follow-up appointments will be necessary to monitor the healing process and assess the function of the tendon. Rehabilitation may include physical therapy to restore strength and range of motion as the graft integrates with the surrounding tissues. It is important for patients to adhere to post-operative care instructions to optimize recovery outcomes.

Short Descr GRAFT HAND OR FINGER TENDON
Medium Descr RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD
Long Descr Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, 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) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
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) P3D - Major procedure, orthopedic - other
MUE 2
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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.
F2 Left hand, third digit
F3 Left hand, fourth digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
LT Left side (used to identify procedures performed on the left 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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