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Official Description

Tenolysis, flexor tendon; palm OR finger, each tendon

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Tenolysis, specifically for a single flexor tendon in the palm or finger, is a surgical procedure aimed at restoring motion in the hand and/or fingers. This procedure is necessary when scar tissue forms around the flexor tendon due to trauma or a disease process, which can severely limit movement. The surgery involves making an incision over the affected tendon, allowing the surgeon to access the underlying structures. Once the incision is made, the surrounding soft tissues are carefully dissected to expose the tendon. The primary goal of the tenolysis is to identify the affected flexor tendon and sever any adhesions that have developed along its length, which are responsible for restricting movement. After the adhesions are released, the surgeon evaluates the range of motion to ensure that the procedure has successfully restored function. Finally, the surgical wound is meticulously closed in layers, and a dressing is applied to protect the area as it heals. It is important to note that the CPT® code 26440 is specifically used for reporting the tenolysis of each separate tendon treated in the palm or finger, distinguishing it from other related procedures such as CPT® code 26442, which involves more extensive tenolysis along the entire length of the tendon.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Tenolysis of a flexor tendon is indicated in cases where there is significant scarring or adhesion formation around the tendon, which can occur due to various factors. The following conditions may warrant this procedure:

  • Trauma The presence of scar tissue resulting from an injury that has affected the flexor tendon, leading to restricted movement.
  • Diseases Conditions such as Dupuytren's contracture or other inflammatory processes that cause adhesion formation around the tendon.
  • Post-surgical complications Adhesions that develop following previous surgical interventions on the hand or fingers, which can impede normal tendon function.

2. Procedure

The tenolysis procedure involves several critical steps to ensure the successful release of adhesions and restoration of tendon function. The following outlines the procedural steps:

  • Step 1: Incision The surgeon begins by making a precise incision over the affected flexor tendon in the palm or finger. This incision is strategically placed to provide optimal access to the tendon while minimizing damage to surrounding tissues.
  • Step 2: Dissection After the incision is made, the surgeon carefully dissects the soft tissues surrounding the tendon. This step is crucial for exposing the tendon and identifying any adhesions that may be present.
  • Step 3: Identification of the tendon Once the tendon is exposed, the surgeon identifies the affected flexor tendon that requires tenolysis. This identification is essential for ensuring that the correct tendon is treated.
  • Step 4: Severing adhesions The surgeon then proceeds to sever the adhesions along the length of the affected tendon. This step is vital for restoring the normal gliding motion of the tendon, which is necessary for hand and finger movement.
  • Step 5: Range of motion evaluation After the adhesions have been released, the surgeon evaluates the range of motion of the finger or hand to assess the effectiveness of the procedure. This evaluation helps determine if further intervention is needed.
  • Step 6: Closure Finally, the surgical wound is closed in layers to promote proper healing. The closure technique is important to minimize scarring and ensure the integrity of the surrounding tissues.
  • Step 7: Dressing application A dressing is applied to the surgical site to protect it from infection and support the healing process.

3. Post-Procedure

Post-procedure care following tenolysis is essential for optimal recovery and includes monitoring the surgical site for signs of infection, managing pain, and ensuring proper wound care. Patients may be advised to engage in physical therapy or rehabilitation exercises to improve range of motion and strength in the affected hand or finger. The recovery process may vary depending on the extent of the procedure and the individual patient's healing response. Regular follow-up appointments are typically scheduled to assess healing progress and to make any necessary adjustments to the rehabilitation plan.

Short Descr RELEASE PALM/FINGER TENDON
Medium Descr TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON
Long Descr Tenolysis, flexor tendon; palm OR finger, each tendon
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) P5B - Ambulatory procedures - musculoskeletal
MUE 6
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).
F8 Right hand, fourth digit
F7 Right hand, third digit
F2 Left hand, third digit
F3 Left hand, fourth digit
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.
RT Right side (used to identify procedures performed on the right side of the body)
F6 Right hand, second digit
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
F4 Left hand, fifth digit
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.)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
LT Left side (used to identify procedures performed on the left side of the body)
F1 Left hand, second digit
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F5 Right hand, thumb
F9 Right hand, fifth digit
FA Left hand, thumb
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
SG Ambulatory surgical center (asc) facility service
T7 Right foot, third digit
TA Left foot, great toe
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
Date
Action
Notes
2003-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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