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Official Description

Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26480 involves the transfer or transplantation of a tendon specifically in the carpometacarpal area or the dorsum of the hand. This surgical intervention is typically performed to restore functionality that may have been compromised due to various conditions, most commonly resulting from traumatic injuries affecting the nerve, tendon, or muscle. In some cases, the loss of function may also stem from chronic conditions such as rheumatoid arthritis or gouty arthritis. The primary goal of this procedure is to re-establish the normal movement and strength of the hand by relocating a tendon from one area to another, thereby compensating for the damaged or non-functional tendon. The complexity of the procedure can vary based on the specific function that the surgeon aims to restore, which may involve careful planning and execution to ensure optimal outcomes for the patient.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The transfer or transplant of a tendon in the carpometacarpal area or dorsum of the hand is indicated for the following conditions:

  • Traumatic Injury - This procedure is often performed to restore function following a traumatic injury to the nerve, tendon, or muscle in the hand.
  • Rheumatoid Arthritis - In some cases, the loss of function may be due to the effects of rheumatoid arthritis, which can damage tendons and impair hand function.
  • Gouty Arthritis - Similar to rheumatoid arthritis, gouty arthritis can lead to tendon damage and loss of function, necessitating surgical intervention.

2. Procedure

The procedure for tendon transfer or transplantation involves several critical steps to ensure successful restoration of hand function:

  • Step 1: Incision and Exposure - A longitudinal incision is made over the donor tendon to expose it adequately. This step is crucial for accessing the tendon that will be transferred.
  • Step 2: Donor Tendon Preparation - The donor tendon is carefully freed from its attachments, allowing it to be secured to the recipient site. This may involve harvesting the tendon along with a strip of periosteum to ensure proper anchoring.
  • Step 3: Muscle Mobilization - In some cases, muscle may also need to be freed from fascial attachments to provide maximum mobility and length for the tendon transfer, enhancing the effectiveness of the procedure.
  • Step 4: Recipient Site Incision - A second incision is made over the recipient site, where the donor tendon will be attached. This site is critical for the successful integration of the transferred tendon.
  • Step 5: Routing and Securing the Donor Tendon - The donor tendon is routed to the recipient site and initially secured with temporary sutures. This allows for adjustments to be made before final fixation.
  • Step 6: Function Testing - A neuromuscular stimulator is utilized to test the function of the donor tendon, ensuring that it is capable of performing the necessary movements.
  • Step 7: Final Tension Adjustment - The tension of the donor tendon is adjusted as needed to optimize function before it is permanently secured at the recipient site.
  • Step 8: Wound Closure - After securing the tendon, the surgical wounds are closed, and the wrist and/or hand may be immobilized as necessary to facilitate healing.

3. Post-Procedure

Post-procedure care involves monitoring the surgical site for any signs of complications and ensuring proper healing. The wrist and/or hand may need to be immobilized to protect the surgical site and allow for adequate recovery. Rehabilitation may be necessary to restore full function, which can include physical therapy to strengthen the hand and improve range of motion. Follow-up appointments will be essential to assess the success of the tendon transfer and to make any necessary adjustments to the rehabilitation plan.

Short Descr TRANSPLANT HAND TENDON
Medium Descr TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
Long Descr Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, 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) 0 - 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 4
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).
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)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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.
FA Left hand, thumb
SG Ambulatory surgical center (asc) facility service
F5 Right hand, thumb
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.)
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).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
GW Service not related to the hospice patient's terminal condition
KX Requirements specified in the medical policy have been met
T6 Right foot, second digit
TA Left foot, great toe
TV Special payment rates, holidays/weekends
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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