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Official Description

Tenolysis, extensor tendon, hand OR finger, each tendon

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Tenolysis is a surgical procedure aimed at releasing an extensor tendon in the hand or finger from scar tissue that has formed due to trauma or a disease process. This procedure is essential for restoring motion to the affected area, allowing for improved functionality of the hand or finger. In the context of CPT® Code 26445, the tenolysis is specifically performed on a single extensor tendon, which is a type of tendon responsible for extending the fingers. The procedure begins with an incision made directly over the affected tendon, allowing the surgeon to access the underlying soft tissues. Once the tendon is exposed, any adhesions or scar tissue that may be restricting movement are carefully lysed, or broken down. After the release of the tendon, the surgeon evaluates the range of motion to assess the effectiveness of the procedure. Following this evaluation, the surgical wound is meticulously closed in layers to promote proper healing, and a dressing is applied to protect the site. It is important to note that CPT® Code 26445 should be reported for each extensor tendon in the hand or finger that is successfully released from scar tissue during the procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of tenolysis, as described by CPT® Code 26445, is indicated for patients who have experienced a loss of motion in their hand or finger due to the formation of scar tissue around an extensor tendon. This condition may arise from various factors, including:

  • Trauma: Injuries to the hand or finger that result in tendon damage and subsequent scarring.
  • Disease Process: Conditions such as rheumatoid arthritis or other inflammatory diseases that can lead to tendon adhesions.

2. Procedure

The tenolysis procedure involves several critical steps to ensure the successful release of the extensor tendon. Each step is essential for achieving the desired outcome of restoring motion to the affected area.

  • Step 1: An incision is made over the affected extensor tendon in the hand or finger. This incision is strategically placed to provide optimal access to the tendon while minimizing damage to surrounding tissues.
  • Step 2: The surgeon carefully dissects the soft tissues surrounding the tendon to expose it fully. This dissection is performed with precision to avoid injury to nearby structures.
  • Step 3: Once the tendon is exposed, any adhesions or scar tissue that are restricting the tendon’s movement are lysed. This step is crucial for freeing the tendon and restoring its function.
  • Step 4: After lysing the adhesions, the surgeon evaluates the range of motion of the tendon to determine the effectiveness of the procedure. This assessment helps in deciding if further intervention is necessary.
  • Step 5: The surgical wound is then closed in layers to ensure proper healing. Layered closure helps to minimize complications and supports the integrity of the surrounding tissues.
  • Step 6: Finally, a dressing is applied to the surgical site to protect it and promote healing. The dressing also aids in managing any postoperative swelling or discomfort.

3. Post-Procedure

After the tenolysis procedure, patients can expect a recovery period that may involve monitoring for signs of infection and managing pain. Rehabilitation may be necessary to regain full range of motion and strength in the hand or finger. Physical therapy may be recommended to facilitate recovery and improve functionality. Patients should follow their surgeon's postoperative care instructions closely to ensure optimal healing and to address any complications that may arise during the recovery process.

Short Descr RELEASE HAND/FINGER TENDON
Medium Descr TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH
Long Descr Tenolysis, extensor tendon, hand 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 5
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
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.
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.
LT Left side (used to identify procedures performed on the left side of the body)
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.
F9 Right hand, fifth digit
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
73 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
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.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AF Specialty physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
T6 Right foot, second digit
TA Left foot, great toe
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2005-01-01 Changed Code description changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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