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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.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 25274 is indicated for the repair of extensor tendons or muscles in the forearm and/or wrist under specific circumstances. These include:
The procedure for CPT® Code 25274 involves several critical steps to ensure effective repair of the extensor tendon or muscle. The process begins with the surgeon making an incision over the site of the affected extensor tendon or muscle to gain access to the damaged area.
Post-procedure care following the repair of extensor tendons or muscles using CPT® Code 25274 involves several important considerations. After the surgical site is closed, the wrist and hand are immobilized with a splint or cast to protect the repair and facilitate healing. Patients are typically monitored for signs of complications, such as infection or improper healing. Rehabilitation may be necessary to restore full function, which can include physical therapy to improve strength and range of motion. The duration of immobilization and rehabilitation will depend on the extent of the injury and the specific surgical repair performed. Follow-up appointments are essential to assess the healing process and make any necessary adjustments to the treatment plan.
| Short Descr | REPAIR FOREARM TENDON/MUSCLE | Medium Descr | RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN | Long Descr | Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 4 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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