CPT code 26145: Tenosynovectomy, palm or finger, each tendon2026 Medicare rate & RVUs in Missouri
Removal of diseased synovial tissue around a flexor tendon in the palm or finger for significant tenosynovitis that impairs tendon gliding.
CMS doesn’t publish an office rate for 26145 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 26145 covers
Code 26145 represents removal of diseased synovial tissue surrounding a flexor tendon in the palm or finger while preserving the tendon itself. A hand surgeon typically performs the procedure for substantial proliferative tenosynovitis that restricts tendon excursion, including inflammatory disease such as rheumatoid arthritis. The operative report should identify the treated tendon and document the synovial disease and extent of the synovectomy.
Report the service for each tendon treated, distinguishing synovectomy from removal of a tendon or excision of a discrete sheath lesion. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 26145 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $471.71 |
| Metropolitan St. Louis, MO | Unavailable | $475.78 |
| Rest of Missouri | Unavailable | $453.48 |
How the 26145 rate is calculated
Each of 26145’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 26145
RVUs × geographic indexes × conversion factor
Work6.33
6.33 RVUs× 1.000 GPCI
Practice expense7.04
7.04 RVUs× 1.000 GPCI
Malpractice1.21
1.21 RVUs× 1.000 GPCI
Adjusted RVUs
14.5800
Conversion factor
$33.4009
Medicare rate
$486.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26145
26145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26145
Tenosynovectomy, palm or finger, each tendon
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26145
Tenosynovectomy, palm or finger, each tendon
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26145 without 51 · national facility
$486.99
Tenosynovectomy, palm or finger, each tendon
26145-51 · Second procedure: 50%
$243.50
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26145 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26160Tendon sheath excisionHand or finger lesion
- Use 26145 for synovectomy around a tendon affected by tenosynovitis. Use 26160 for excision of a discrete tendon-sheath or joint-capsule lesion, such as a cyst.
- 26170Tendon excisionPalm, each tendon
- 26170 removes a tendon in the palm. Code 26145 removes diseased synovial tissue around a flexor tendon while preserving the tendon.
- 26180Tendon excisionFlexor tendon, finger
- 26180 removes a tendon in a finger. Code 26145 is for synovectomy around a flexor tendon, not excision of the tendon itself.
26145 billing questions
Does this code describe removal of the tendon?
No. It describes removal of diseased synovial tissue around a flexor tendon; the tendon itself is preserved. Tendon excision is represented by a different procedure.
How is the number of tendons reflected in reporting?
The service is described per tendon. The operative note should identify each tendon treated and document the synovectomy performed.
How does this differ from 26160?
26145 addresses diseased synovium around a tendon. Code 26160 is for excision of a discrete lesion of the tendon sheath or joint capsule, such as a cyst.
Does the 90-day global include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be used for both hands or fingers?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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