CPT® Code 25274

Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle

The procedure described by CPT® Code 25274 involves the repair of extensor tendons or muscles located in the forearm and/or wrist, specifically through a secondary approach that utilizes a free graft. Extensor tendons and muscles are critical for the extension movements of the wrist, hand, and fingers, originating from anatomical landmarks such as the lateral epicondyle and lateral supracondylar ridge of the humerus, as well as the proximal dorsal surface of the ulna. Common extensor muscles include the extensor carpi radialis longus, extensor carpi ulnaris, extensor digitorum, and extensor indicis. Injuries to these structures can be either open, such as lacerations or punctures, or closed, such as ruptures or avulsions, necessitating surgical intervention for repair. During the procedure, an incision is made over the affected area to access the extensor tendon or muscle. If the tendon is completely severed, the surgeon locates the ends of the tendon, which may involve pulling them distally or proximally to facilitate repair. In cases of partial transection, the surgeon repairs the damaged fibers directly. For lacerated or torn muscles, a layered repair technique is employed to restore the muscle tissue. If the primary repair does not yield satisfactory functional results, a secondary repair may be indicated, which is where CPT® Code 25274 comes into play. This code specifically applies when a free graft is required to achieve a successful repair. The graft is harvested locally and meticulously attached to the remnants of the severed tendon, ensuring proper alignment and tension to restore optimal range of motion. Following the repair, the surgical site is closed in layers, and the wrist and hand are immobilized to promote healing.