CPT® Code 26485

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.