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

Transfer of tendon to restore intrinsic function; all 4 fingers

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 26498 refers to the surgical procedure known as the transfer of tendon to restore intrinsic function in all four fingers. This procedure is indicated for patients experiencing a loss of intrinsic function, which can lead to a condition commonly referred to as claw hand or claw finger. This condition arises from an imbalance between the intrinsic and extrinsic muscles of the hand, resulting in difficulty with finger movement and function. The intrinsic muscles, which are responsible for fine motor control and coordination of the fingers, may become weakened or dysfunctional, leading to the characteristic claw-like appearance of the fingers. The transfer of the flexor digitorum superficialis (FDS) tendon is a surgical intervention aimed at enhancing the intrinsic function of the fingers by substituting for the roles typically performed by the interosseous and lumbrical muscles. This procedure not only alleviates some of the clawing but also improves flexion at the metacarpophalangeal (MCP) joint, thereby restoring better hand function and enhancing the patient's quality of life.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 26498 is indicated for patients who exhibit a loss of intrinsic function in all four fingers, leading to the development of claw hand or claw finger. This condition is characterized by an imbalance between the intrinsic and extrinsic muscles of the hand, resulting in impaired finger movement and functionality. The following conditions may warrant the performance of this procedure:

  • Claw Hand A condition where the fingers are bent in a claw-like position due to the loss of intrinsic muscle function.
  • Intrinsic Muscle Dysfunction Weakness or paralysis of the intrinsic muscles that control fine motor movements of the fingers.
  • Impaired Finger Flexion Difficulty in flexing the fingers at the metacarpophalangeal (MCP) joint, affecting overall hand function.

2. Procedure

The procedure for CPT® Code 26498 involves several detailed steps to effectively transfer the tendon and restore function. The following outlines the procedural steps:

  • Step 1: Preparation The patient is positioned appropriately, and the surgical site is prepared and sterilized to minimize the risk of infection.
  • Step 2: Incision A surgical incision is made to access the flexor digitorum superficialis (FDS) tendon in the forearm, allowing for the necessary tendon transfer.
  • Step 3: Tendon Detachment The FDS tendon is carefully detached from its insertion point on the ring finger, ensuring that the tendon remains intact for the transfer process.
  • Step 4: Splitting the Tendon The detached FDS tendon is split longitudinally into two halves, which will be routed to restore function in the fingers.
  • Step 5: Dorsal Passage One half of the FDS tendon is passed dorsally through the first interosseous muscle, allowing it to connect with the necessary structures for improved function.
  • Step 6: Volar Tunneling The other half of the FDS tendon is passed volarly and tunneled to the lumbrical muscle, facilitating the restoration of intrinsic function in all four fingers.
  • Step 7: Closure Once the tendon transfer is complete, the incision is closed using appropriate suturing techniques, and the surgical site is dressed.

3. Post-Procedure

After the completion of the tendon transfer procedure, patients typically undergo a recovery period that may involve immobilization of the hand to allow for proper healing of the tendon. Physical therapy may be recommended to help restore strength and flexibility in the fingers, as well as to improve overall hand function. Patients are monitored for any signs of complications, such as infection or improper healing, and follow-up appointments are scheduled to assess the success of the procedure and make any necessary adjustments to the rehabilitation plan.

Short Descr FINGER TENDON TRANSFER
Medium Descr TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS
Long Descr Transfer of tendon to restore intrinsic function; all 4 fingers
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 1
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).
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).
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. 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.
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.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F6 Right hand, second digit
GC This service has been performed in part by a resident under the direction of a teaching physician
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)
Date
Action
Notes
2010-01-01 Changed Code description changed.
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"