CPT® Code 26489

The procedure described by CPT® Code 26489 involves the transfer or transplantation of a tendon located in the palm of the hand, specifically utilizing a free tendon graft. This surgical intervention is typically 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 based on the specific function that the surgeon aims to restore, which necessitates a tailored approach to each individual case.

During the procedure, 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 provide additional support. Furthermore, to maximize the mobility and length of the tendon transfer, the associated muscle may also be released from its fascial attachments. 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. A neuromuscular stimulator is employed to assess the functionality of the donor tendon, allowing for adjustments in tension to optimize performance before the tendon is permanently secured. After the surgical wounds are closed, immobilization of the wrist and/or hand is implemented as necessary to facilitate recovery.