Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Shortening of tendon, extensor, hand or finger, each tendon

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26477 involves the shortening of an extensor tendon in the hand or finger. This surgical intervention is typically indicated for patients who present with an extension deformity, which can arise from various conditions, including the late effects of injuries or degenerative diseases such as severe rheumatoid arthritis or osteoarthritis. In cases where the extensor tendon is excessively long, it can lead to functional impairments and discomfort, necessitating surgical correction. The shortening procedure aims to restore normal function and alignment by reducing the length of the tendon. This is achieved through a surgical technique where the tendon is divided, and the ends are overlapped and sutured together, effectively shortening the tendon. Following the procedure, the affected hand or finger is immobilized in a splint to ensure proper healing and to maintain the new tendon length until recovery is complete. It is important to note that this code is applicable for each tendon that is shortened during the procedure, emphasizing the need for accurate reporting in medical coding practices.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 26477 is indicated for the following conditions:

  • Extension Deformity An extension deformity in the hand or finger, which may result from various underlying issues, necessitating surgical intervention to restore normal function.
  • Late Effects of Injuries Conditions arising from previous injuries that have led to abnormal tendon length or function, requiring correction through tendon shortening.
  • Severe Rheumatoid Arthritis A chronic inflammatory disorder that can cause joint damage and deformities, including extension deformities of the fingers or hand.
  • Osteoarthritis A degenerative joint disease that may lead to structural changes in the hand or fingers, contributing to the need for tendon shortening to improve function.

2. Procedure

The procedure for shortening an extensor tendon involves several key steps:

  • Step 1: Incision A skin incision is made over the extensor tendon that requires shortening. This incision allows access to the tendon while minimizing damage to surrounding tissues.
  • Step 2: Dissection The soft tissues surrounding the tendon are carefully dissected to expose the tendon fully. This step is crucial to ensure that the tendon can be manipulated without causing unnecessary trauma to adjacent structures.
  • Step 3: Division of the Tendon The extensor tendon is then divided at the appropriate location. This division is essential for the subsequent steps that will allow for the shortening of the tendon.
  • Step 4: Overlapping and Suturing After the tendon is divided, the ends of the tendon are overlapped and sutured together. This overlapping technique effectively shortens the tendon, allowing for improved alignment and function of the hand or finger.
  • Step 5: Immobilization Following the suturing of the tendon, the hand or finger is immobilized in a splint. This immobilization is critical to maintain the new length of the tendon and to facilitate proper healing during the recovery period.

3. Post-Procedure

After the procedure, the patient will typically be required to keep the hand or finger immobilized in a splint for a specified duration to ensure that the tendon heals properly in its new position. The immobilization helps to prevent movement that could disrupt the healing process. Patients may also be advised on pain management strategies and follow-up appointments to monitor the healing progress. Rehabilitation exercises may be introduced gradually, depending on the surgeon's recommendations, to restore function and strength to the hand or finger once healing has progressed adequately.

Short Descr TENDON SHORTENING
Medium Descr SHORTENING TENDON EXTENSOR HAND/FINGER EACH
Long Descr Shortening of tendon, extensor, 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) 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
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).
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.
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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.)
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
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
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)
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
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"