CPT code 26418: Finger tendon repair, without free graft2026 Medicare rate & RVUs in Louisiana
Reports repair of a finger extensor tendon without a free graft, when the surgeon restores tendon continuity after an injury or disruption.
CMS doesn’t publish an office rate for 26418 in Louisiana.
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 26418 covers
A hand surgeon typically uses this service to restore continuity of an injured or disrupted extensor tendon in a finger, allowing the tendon to transmit force for extension. The repair is performed in an operative setting and may follow an acute laceration or address a tendon injury requiring operative repair. This code describes repair without a free tendon graft; a repair requiring graft reconstruction belongs to a different code choice.
Select the code based on the finger tendon repaired and the operative method, not simply the diagnosis. The operative report should identify the tendon and finger, describe the repair, and establish that no free graft was used. It has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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 26418 pays more and less in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | Unavailable | $604.70 |
| Rest of Louisiana | Unavailable | $574.25 |
How the 26418 rate is calculated
Each of 26418’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 · 26418
RVUs × geographic indexes × conversion factor
Work4.36
4.36 RVUs× 1.000 GPCI
Practice expense13.58
13.58 RVUs× 1.000 GPCI
Malpractice0.85
0.85 RVUs× 1.000 GPCI
Adjusted RVUs
18.7900
Conversion factor
$33.4009
Medicare rate
$627.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26418
26418 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26418
Finger tendon repair, without free 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) | 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 · 26418
Finger tendon repair, without free 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
26418 without 51 · national facility
$627.60
Finger tendon repair, without free graft
26418-51 · Second procedure: 50%
$313.80
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%).
26418 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26420Tendon repairFinger, with free graft
- Choose 26418 for a finger extensor tendon repair without a free graft; 26420 describes the grafted repair.
- 26410Hand tendon repairExtensor tendon, without graft
- 26410 addresses extensor tendon repair in the hand. 26418 is the finger-specific repair code.
- 26415Tendon excisionHand or finger
- 26415 describes tendon excision, not restoration of tendon continuity. Report 26418 when the operative service is repair.
26418 billing questions
How does this differ from 26420?
26418 is for finger extensor tendon repair without a free graft. Use 26420 when the repair requires a free graft.
What documentation supports reporting 26418?
Document the finger and tendon repaired, the nature of the tendon injury, and the operative technique showing repair without a free graft.
Can the surgeon report a separate assistant-at-surgery service?
Medicare does not pay an assistant at surgery for 26418. Co-surgeons and team surgery are also not permitted.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used when both hands are treated?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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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