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Official Description

Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 25280 involves the surgical lengthening or shortening of a flexor or extensor tendon located in the forearm and/or wrist. This intervention is typically indicated for patients who present with a flexion or extension deformity of the wrist, which may arise from various causes, including the late effects of injuries or degenerative conditions such as severe rheumatoid arthritis or osteoarthritis. The surgical approach begins with making a skin incision over the targeted tendon, followed by careful dissection of the surrounding soft tissues to expose the tendon. For lengthening, a Z-shaped incision is created in the tendon, allowing the tendon fibers to separate and elongate as the wrist is flexed or extended. Conversely, if shortening is required, the tendon is divided, and the ends are overlapped and sutured together. Post-surgery, the wrist is immobilized using a splint or cast to maintain the desired position during the healing process. It is important to note that this code is applicable for the lengthening or shortening of a single tendon; if multiple tendons require similar procedures, the code should be reported for each tendon involved.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure coded by CPT® Code 25280 is indicated for the correction of flexion or extension deformities of the wrist. These deformities may result from various underlying conditions or injuries, including:

  • Late Effects of Injuries Deformities that develop as a consequence of previous trauma to the wrist or forearm.
  • Severe Rheumatoid Arthritis A chronic inflammatory disorder that can lead to joint deformities and functional impairments.
  • Osteoarthritis A degenerative joint disease that can cause pain, stiffness, and deformity in the wrist and surrounding structures.

2. Procedure

The procedure for lengthening or shortening a tendon involves several key steps, which are detailed as follows:

  • Step 1: Incision and Exposure A skin incision is made directly over the tendon that is to be lengthened or shortened. The surgeon carefully dissects the surrounding soft tissues to expose the tendon, ensuring minimal damage to adjacent structures.
  • Step 2: Lengthening the Tendon If the procedure involves lengthening, a Z-shaped incision is made in the tendon. This specific incision allows the tendon fibers to slide apart, effectively lengthening the tendon as the wrist is flexed or extended. The surgeon then places sutures in the tendon to secure it in the lengthened position.
  • Step 3: Shortening the Tendon In cases where shortening is necessary, the tendon is divided. The ends of the divided tendon are then overlapped and sutured together to achieve the desired length.
  • Step 4: Immobilization After the tendon has been lengthened or shortened, the wrist is immobilized using a splint or cast. This immobilization is crucial to maintain the wrist in the desired position and to facilitate proper healing of the tendon.

3. Post-Procedure

Following the procedure, patients are typically required to keep the wrist immobilized in a splint or cast to ensure that the tendon heals properly in its new position. The duration of immobilization may vary based on the specific case and the surgeon's recommendations. Patients may also need to engage in rehabilitation exercises after the immobilization period to restore function and strength to the wrist. Regular follow-up appointments are essential to monitor the healing process and to address any complications that may arise.

Short Descr REVISE WRIST/FOREARM TENDON
Medium Descr LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN
Long Descr Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon
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 9
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).
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)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
F1 Left hand, second digit
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.
SG Ambulatory surgical center (asc) facility service
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
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
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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