Single tendon transplantation or transfer of a flexor or extensor tendon in the forearm and/or wrist, without tendon graft.

Verified May 8, 2026 · 7 sources ↓

Medicare: $668.35
Work RVU: 8.78
Global, days: 90
Region: Wrist

Drawn from CMSAbosAAPCFindacodeEatonhand

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Specify which tendon(s) were transferred by name (e.g., EIP to EPL, FDS to EIP) — generic references to 'tendon transfer' will not support the code.
Confirm the procedure site is the forearm and/or wrist; transfers at the palm level are coded differently.
State explicitly that no free tendon graft was harvested or used; if graft was obtained, 25312 applies.
Document the indication: tendon rupture, neurologic deficit, rheumatoid destruction, or other pathology requiring functional reconstruction.
Record the donor tendon source, insertion point, and tensioning technique to support medical necessity and distinguish from tenodesis (25300–25301).
For multiple tendons transferred in the same session, document each tendon separately to support billing additional units.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 25310 covers a single flexor or extensor tendon transplantation or transfer in the forearm and/or wrist, performed without a free tendon graft. The surgeon reroutes a functioning tendon to a new insertion point to restore motion or strength lost to injury, rupture, or neuromuscular disease. Common clinical scenarios include EPL rupture after distal radius fracture, radial nerve palsy requiring extensor tendon transfers, and tendon transfers in rheumatoid arthritis or post-traumatic dysfunction.

Each tendon transferred is reported separately under 25310. If the procedure requires harvesting and incorporating a free tendon graft, report 25312 instead — that distinction is the most common upcoding or downcoding error auditors flag. Procedures performed on the palm fall under the 26480–26489 series, not 25310.

The 90-day global period covers all routine post-operative management through day 90, including splinting, wound checks, and suture removal. Unrelated E/M visits or new injuries managed during the global period require modifier 24. A same-day E/M that drives the surgical decision needs modifier 25.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (8.78) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.01) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	8.78
Practice expense RVU	9.56
Malpractice RVU	1.67
Total RVU	20.01
Medicare national rate	$668.35
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$668.35
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 25310 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billing 25310 when a free tendon graft was used — payers expect 25312 and will deny or downcode 25310.
Insufficient operative note detail: notes that reference only 'standard tendon transfer' without naming donor and recipient tendons are flagged on audit.
Unbundling denials when 25310 is billed alongside tenolysis (25295) or tendon lengthening (25280) performed on the same tendon in the same session.
Missing laterality modifier (LT or RT) on payers that require it — a common clean-claim failure with hand and forearm codes.
Global period conflicts: post-op E/M visits billed without modifier 24 during the 90-day global are automatically denied.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 25310 and 25312?

25310 is the correct code when the tendon is transferred without a free graft. If a free tendon graft is harvested and used as part of the reconstruction, report 25312 instead. Using 25310 when a graft was taken is a downcoding error; using 25312 without graft documentation is an upcoding risk.

02Can 25310 be billed for each tendon transferred in the same session?

Yes. The code descriptor specifies 'each tendon,' so if two tendons are transferred during the same operative session, report 25310 twice. Append modifier 51 to the secondary procedure. Document each tendon transfer separately in the operative note.

03How does 25310 differ from palmar tendon transfer codes like 26485?

25310 applies when the transfer is performed in the forearm and/or wrist. Tendon transfers in the palm are coded from the 26480–26489 series. If the operative site spans both regions, code selection should reflect the primary anatomic site of the transfer.

04What modifiers are needed when billing 25310 bilaterally?

Append modifier 50 if both forearms are treated in the same session and your payer accepts bilateral billing on a single line. Some payers require separate lines with LT and RT. Confirm payer preference before submission — Medicare follows the single-line modifier 50 convention.

05Is a pre-operative E/M on the day of surgery separately billable?

Only if the E/M was for a separate problem unrelated to the tendon transfer. If the visit drove the decision to operate on the same condition, it is folded into the global and not separately billable. If it addressed a distinct diagnosis, append modifier 25 and document that distinction clearly.

06What happens if a complication requires returning to the OR for the same tendon during the 90-day global?

An unplanned return to the OR for a complication related to the original tendon transfer is reported with modifier 78. An unrelated procedure performed during the global period uses modifier 79. Do not invert these — incorrect modifier use is a common audit finding.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the transferred tendon by name, the recipient insertion site, confirmation that no free graft was harvested, and the clinical indication driving the transfer — all from dictation. That specificity prevents the two most common denials: upcoding to 25312 when no graft was used, and audit flags from operative notes that lack donor-recipient tendon documentation.

See how Mira captures CPT 25310 documentation