Soft-Tissue Procedures — Tenotomy & Intramuscular Lengthening
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PURPOSE
Percutaneous tenotomies AND intramuscular (fractional) lengthenings — adductors, hamstrings, and the gastrocnemius-soleus complex (Strayer), plus Achilles. Common in CP and spasticity work as well as clubfoot. Small, precise setup with sharp blade options; a defined open soft-tissue tray is available when a lengthening is done open.
| CPT / PROCEDURES | |
| Achilles tenotomy — percutaneous (local / general) | 27605 / 27606 |
| Adductor tenotomy of hip — percutaneous (open: 27001; +obturator neurectomy: 27003) | 27000 |
| Tenotomy, percutaneous, adductor or hamstring — single / multiple | 27306 / 27307 |
| Hamstring lengthening — single / multiple 1 leg / bilateral | 27393 / 27394 / 27395 |
| Hamstring tenotomy, open, knee to hip — single / mult 1 leg / bilat | 27390 / 27391 / 27392 |
| Lengthening of tendon, leg or ankle — single / multiple | 27685 / 27686 |
| Gastrocnemius recession (e.g., Strayer) | 27687 |
| Application of clubfoot cast with molding / manipulation | 29450 |
| Note Most tenotomy/lengthening codes are separate-procedure and laterality / single-vs-multiple-tendon specific — confirm the exact tendon, side, and count per case. Ponseti final-cast application is 29450. | |
PERCUTANEOUS SUPPLIES & BEAVER / MICRO-BLADE SYSTEM
- 10 cc syringe · 22-, 25-, and 27-gauge needles · 0.25% Marcaine w/ epi for incision injection.
- Bayonet handles x2 · Beaver 6900 blade (blue, double-sided / sharp all around) · Beaver 6700-series (orange, #15-style).
- SYLKE silk-fibroin skin closure (preferred) or 1/4-inch Steri-Strips · Mastisol liquid adhesive.
OPEN SOFT-TISSUE TRAY (FOR OPEN LENGTHENINGS)
- #3 scalpel handle with #15 blade (the #3 handle is the correct handle for a #15 blade).
- Weitlaner self-retaining retractors: 2x3-prong x2 and 4x3-prong x2.
- Senn retractors · Ragnell retractors · Army-Navy retractors x2 · Freer elevators x2.
- Metzenbaum scissors, 7 in dissecting · tenotomy scissors · McCabe dissecting scissors x1.
- Allis clamps x2 · Schnidt hemostatic (tonsil) forceps, 7.25 in, slightly curved.
- Mayo-Hegar needle holder, 8 in x1 · Gerald forceps · Adson forceps x2.
- Edna non-perforating towel clamps x2 · Backhaus towel clips, sharp, 5.5 in x2.