CPT code 26180: Tendon excision, flexor tendon, finger2026 Medicare rate & RVUs in Texas
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 doesn’t publish an office rate for 26180 in Texas.
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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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $440.71 |
| Beaumont, TX | Unavailable | $408.72 |
| Brazoria, TX | Unavailable | $423.24 |
| Dallas, TX | Unavailable | $427.14 |
| Fort Worth, TX | Unavailable | $425.34 |
| Galveston, TX | Unavailable | $425.29 |
| Houston, TX | Unavailable | $443.60 |
| Rest of Texas | Unavailable | $416.57 |
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
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
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 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.
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%).
26180 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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