CPT® Code 24320

The CPT® Code 24320 refers to a surgical procedure known as tenoplasty, which involves the repair of a tendon through the transfer of muscle. This procedure is specifically designed to stabilize the elbow and upper arm, as well as to restore function to these areas. The term 'tenoplasty' indicates that the focus is on the repair of the tendon, while the muscle transfer aspect involves relocating a muscle to enhance the effectiveness of the repair. There are various techniques utilized in this procedure, including the local transfer of an existing muscle from the elbow or upper arm to a new site, or the free transfer of a muscle that is expendable, such as the gracilis muscle from the thigh. During the procedure, a skin incision is made over the elbow or upper arm to access the injured or atrophied tendon. The surgeon carefully identifies the tendon and dissects the surrounding neurovascular structures to protect them during the operation. The injured tendon is then detached and may undergo debridement to remove any damaged tissue. In some cases, the tendon is sliced open to facilitate the removal of scar tissue. The site where the tendon will be reattached—whether on the shoulder, upper arm, or elbow—is drilled to create a secure anchor point. The repaired tendon is then affixed to this new site using a fixing wire that is pulled through the drill hole, or alternatively, screw fixation may be employed to secure a bone fragment that is connected to the tendon. If a local muscle transfer is performed, the existing bony attachments of the muscle are severed, and the muscle is reattached at the new site. In cases where a free muscle transfer is indicated, a separate incision is made over the muscle to be harvested, which is excised along with its nerve and blood supply. This excised muscle is then trimmed as necessary and sutured to the bones of the shoulder, upper arm, or elbow in a manner that stabilizes the joint and facilitates the reinnervation of the muscle, ultimately restoring motion. The CPT® Code 24320 specifically reports a single muscle or tendon transfer, highlighting the focused nature of this surgical intervention.