CPT® Code 26428

Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger

The procedure described by CPT® Code 26428 involves the repair of the extensor tendon, specifically the central slip, which is a critical component in the function of the fingers. The extensor tendons are responsible for straightening the fingers, and the central slip is the tendon that attaches to the middle phalanx, allowing for proper extension at the proximal interphalangeal joint. When the central slip is damaged, it can lead to a condition known as a boutonniere deformity, characterized by the inability to fully straighten the finger at this joint. This injury can occur due to various reasons, including a forceful impact to a bent finger, a laceration that severs the tendon, or conditions such as rheumatoid arthritis. The repair procedure classified under this code is considered a secondary repair, which is typically performed after a primary repair has failed or after a significant delay following the initial injury. The surgical approach involves making an incision over the affected area to expose the extensor tendon and central slip, allowing for the necessary repair techniques to be employed. In this case, a free graft is utilized, which involves harvesting a tendon from another site, such as the forearm or leg, to replace the damaged tendon. This method is essential for restoring the function of the finger and ensuring proper healing and alignment of the extensor mechanism.