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Official Description

Transfer or transplant of tendon, palmar; without free tendon graft, each tendon

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 26485 involves the transfer or transplantation of a tendon located in the palm of the hand, specifically without the use of a free tendon graft. This surgical intervention is primarily performed to restore functionality that may have been compromised due to traumatic injuries affecting the nerve, tendon, or muscle. In some cases, the loss of function may also arise from conditions such as rheumatoid arthritis or gouty arthritis. The complexity of the procedure can vary significantly based on the specific function that the surgeon aims to restore. During the operation, a longitudinal incision is made over the donor tendon to expose it adequately. The surgeon meticulously frees the donor tendon from its attachments, ensuring that it can be securely anchored to the recipient site. This process may involve harvesting the tendon along with a strip of periosteum to enhance stability. Additionally, the surgeon may need to release muscle from its fascial attachments to maximize the mobility and length of the tendon being transferred. A second incision is then created at the recipient site, where the donor tendon will be affixed. The donor tendon is routed to this site and temporarily secured with sutures. To ensure proper function, a neuromuscular stimulator is employed to test the donor tendon, allowing for adjustments in tension as necessary before the tendon is permanently secured. After the surgical wounds are closed, immobilization of the wrist and/or hand is implemented as required to facilitate recovery. It is important to note that CPT® Code 26485 is applicable for each tendon that is transplanted or transferred without the use of a tendon graft, while CPT® Code 26489 should be used when a tendon graft is necessary to achieve the desired length.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 26485 is indicated for the following conditions:

  • Traumatic Injury Restoration of function due to damage to the nerve, tendon, or muscle resulting from an accident or injury.
  • Rheumatoid Arthritis Addressing loss of function that may occur as a complication of rheumatoid arthritis, which can affect the tendons and joints in the hand.
  • Gouty Arthritis Treatment of functional impairment caused by gouty arthritis, which can lead to tendon damage and loss of mobility.

2. Procedure

The procedure for tendon transfer or transplantation as outlined in CPT® Code 26485 involves several critical steps:

  • Step 1: Incision Over Donor Tendon A longitudinal incision is made over the donor tendon to expose it. This initial step is crucial for accessing the tendon that will be transferred.
  • Step 2: Freeing the Donor Tendon The surgeon carefully frees the donor tendon from its surrounding attachments. This process is essential to ensure that the tendon can be moved to the recipient site without any restrictions.
  • Step 3: Harvesting the Tendon In some cases, the donor tendon may be harvested along with a strip of periosteum, which provides additional support when the tendon is secured at the recipient site.
  • Step 4: Muscle Release The surgeon may also need to release muscle from its fascial attachments to allow for maximum mobility and length of the tendon being transferred, which is vital for restoring function.
  • Step 5: Incision Over Recipient Site A second incision is made at the recipient site where the donor tendon will be attached. This site is carefully selected to ensure optimal function post-surgery.
  • Step 6: Routing and Securing the Donor Tendon The donor tendon is routed to the recipient site and temporarily secured with sutures. This step allows for initial positioning before final adjustments are made.
  • Step 7: Testing Donor Tendon Function A neuromuscular stimulator is utilized to test the function of the donor tendon. This testing is critical to ensure that the tendon is functioning properly before final fixation.
  • Step 8: Adjusting Tension The tension of the donor tendon is adjusted as needed to ensure maximum function. This adjustment is vital for achieving the desired outcome of the procedure.
  • Step 9: Permanent Securing Once the tension is appropriately adjusted, the donor tendon is permanently secured at the recipient site, completing the transfer process.
  • Step 10: Closure and Immobilization After the surgical wounds are closed, the wrist and/or hand is immobilized as necessary to promote healing and recovery.

3. Post-Procedure

Post-procedure care following the tendon transfer or transplantation involves monitoring the surgical site for any signs of infection or complications. The wrist and/or hand will typically be immobilized to ensure proper healing and to prevent any undue stress on the newly positioned tendon. Patients may be advised on rehabilitation exercises to gradually restore function and strength to the hand, but these should be initiated only under the guidance of a healthcare professional. Follow-up appointments will be necessary to assess the healing process and the effectiveness of the tendon transfer in restoring function.

Short Descr TRANSPLANT PALM TENDON
Medium Descr TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
Long Descr Transfer or transplant of tendon, palmar; without free tendon 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) 2 - Payment restriction for assistants at surgery does not apply 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 4
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
LT Left side (used to identify procedures performed on the left side of the body)
FA Left hand, thumb
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.
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).
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.
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.
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
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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
T5 Right foot, great toe
TA Left foot, great toe
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
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