CPT code 26412: Tendon repair, hand, secondary with graft2026 Medicare rate & RVUs in Maryland
Reports secondary reconstruction of a hand extensor tendon using a free tendon graft when the repair requires graft material to restore continuity.
CMS doesn’t publish an office rate for 26412 in Maryland.
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 26412 covers
This code covers secondary reconstruction of an extensor tendon in the hand when a free tendon graft is needed to bridge a defect or restore tendon length and continuity. It is generally performed by a hand, orthopedic, or plastic surgeon in an operating room, often for a delayed tendon injury or a tendon that cannot be repaired directly because of a gap or scarring. The graft may be harvested during the procedure; obtaining the graft is included in this service.
Report the code for each tendon treated, and document the hand tendon involved, the secondary nature of the repair, why direct repair was inadequate, and the graft used. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 requires documentation of 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 26412 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $740.77 |
| Rest of Maryland | Unavailable | $699.53 |
| Washington, DC area | Unavailable | $790.39 |
How the 26412 rate is calculated
Each of 26412’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 · 26412
RVUs × geographic indexes × conversion factor
Work6.32
6.32 RVUs× 1.000 GPCI
Practice expense13.29
13.29 RVUs× 1.000 GPCI
Malpractice1.21
1.21 RVUs× 1.000 GPCI
Adjusted RVUs
20.8200
Conversion factor
$33.4009
Medicare rate
$695.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26412
26412 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26412
Tendon repair, hand, secondary with graft
| 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 · 26412
Tendon repair, hand, secondary with graft
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
26412 without 51 · national facility
$695.41
Tendon repair, hand, secondary with graft
26412-51 · Second procedure: 50%
$347.71
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%).
26412 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26410Hand tendon repairExtensor tendon, without graft
- Choose 26410 for hand extensor tendon repair without a free graft; 26412 involves secondary repair with a free graft.
- 26416Tendon graftHand or finger
- 26416 describes a tendon graft service. 26412 is the secondary hand tendon repair with graft incorporated into the reconstruction.
- 26420Tendon repairFinger, with free graft
- 26420 is the related graft repair code for a finger tendon. Use 26412 for the hand tendon service.
26412 billing questions
When should 26412 be chosen instead of 26410?
Use 26412 when secondary repair of a hand extensor tendon requires a free graft. The no-free-graft repair is the distinguishing feature of 26410.
Is graft harvesting separately reported?
No. Obtaining the free graft is included in this repair.
How many units should be reported?
Report one unit for each tendon repaired with a free graft, supported by the operative report.
What should the operative note establish?
Document the tendon and hand treated, the secondary repair, why direct repair was insufficient, and the graft used.
Can modifier 50 be used for repairs on both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
When is assistant-at-surgery payment allowed?
Payment is allowed only when the record documents 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
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