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CPT code 26180: Tendon excision, flexor tendon, finger2026 Medicare rate & RVUs

Reports surgical removal of a flexor tendon in a finger when the tendon itself is excised, rather than released, freed, or treated through its sheath.

CMS RVU26DEffective Oct 1, 2026109 payment localities2K Medicare services in 2024

Medicare pays $431.21 for 26180 nationally in a facility.

Medicare rate · 26180

Tendon excision, flexor tendon, finger

Office or facility?

Work RVUs
5.22
Total RVUs
12.91
Global days
090

National rate · 2026

$431.21

Facility setting, before claim adjustments.

See every locality for 26180 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 26180 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26180 covers

A hand surgeon removes a flexor tendon within a finger when the tendon itself is the operative target. The procedure may be performed in a hospital or ambulatory surgery setting for a damaged or diseased tendon that requires excision. The operative report should identify the digit and tendon, describe the condition prompting surgery, and document that tendon tissue was removed.

Report the service for each tendon excised in the finger; removal of tendon sheath tissue alone, release of a constricting sheath, or freeing an adherent tendon describes a different service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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 26180 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

26180 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$388.78
AlaskaUnavailable$517.91
ArizonaUnavailable$419.47
ArkansasUnavailable$383.50
Atlanta, GAUnavailable$442.02
Austin, TXUnavailable$440.71
Bakersfield, CAUnavailable$442.91
Baltimore area, MDUnavailable$458.22
Beaumont, TXUnavailable$408.72
Brazoria, TXUnavailable$423.24

26180 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
26180 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 26180 rate is calculated

Each of 26180’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 · 26180

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.22

5.22 RVUs× 1.000 GPCI

Practice expense6.69

6.69 RVUs× 1.000 GPCI

Malpractice1.00

1.00 RVUs× 1.000 GPCI

Adjusted RVUs

12.9100

Conversion factor

$33.4009

Medicare rate

$431.21

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26180

26180 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26180

Tendon excision, flexor tendon, finger

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26180

Tendon excision, flexor tendon, finger

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26180 without 51 · national facility

$431.21

Tendon excision, flexor tendon, finger

26180-51 · Second procedure: 50%

$215.61

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%).

When to use modifier 51

26180 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 26180

    Tendon excision, flexor tendon, finger5.22 wRVU

    Not priced

  • 26170

    Tendon excision, palm, each tendon4.79 wRVU

    Not priced

  • 26145

    Tenosynovectomy, palm or finger, each tendon6.33 wRVU

    Not priced

  • 26055

    Trigger finger release, finger tendon sheath3.03 wRVU

    $629.61

  • 26440

    Flexor tenolysis, palm and finger5.03 wRVU

    Not priced

How to choose

26170Tendon excisionPalm, each tendon
Both concern flexor tendon excision, but 26170 is for a tendon in the palm; this code is for a tendon within a finger.
26145TenosynovectomyPalm or finger, each tendon
26145 treats the flexor tendon sheath through synovectomy. This code removes the finger flexor tendon itself.
26055Trigger finger releaseFinger tendon sheath
26055 releases a constricting sheath, commonly for trigger finger. Use this code when the finger flexor tendon itself is excised.
26440Flexor tenolysisPalm and finger
26440 frees an adherent flexor tendon while preserving it; this code describes removal of the tendon.

Codes related to 26180

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 26180
CodeHow it relatesNational office range
Same family
26170Tendon excision, palm, each tendonFlexor tendon excision in the palm rather than within a finger.No office rate
Used instead
26145Tenosynovectomy, palm or finger, each tendonFlexor tendon sheath synovectomy when the sheath, rather than the tendon, is treated.No office rate
26055Trigger finger release, finger tendon sheathTrigger finger release opens the flexor sheath without excising the tendon.$548.44–$856.74
26440Flexor tenolysis, palm and fingerFlexor tenolysis frees an adherent tendon rather than removing it.No office rate
26160Tendon sheath excision, hand or finger lesionRemoval of a tendon-sheath lesion when the lesion is the operative target.$573.74–$889.79

26180 billing questions

How does this differ from flexor tendon sheath surgery?

This code is for removal of the finger flexor tendon itself. Sheath removal or synovectomy is a different service when the tendon is not excised.

Is this the code for trigger finger release?

No. Trigger finger release opens the constricting flexor tendon sheath; it does not describe excision of the finger flexor tendon.

How should units be supported?

Document each tendon removed and the finger involved. The code is described per tendon, so the operative record should support the reported count.

Are related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.

Can modifier 50 be used when both hands are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

When is an assistant at surgery payable?

Medicare pays for an assistant at surgery only when documentation establishes medical necessity. 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
RVUs for 26180PPRRVU2026_Oct_nonQPP.csv, line 2,560 (RVU26D)

Open CMS sourceHow we calculate rates

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