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CPT code 26428: Finger tendon repair, secondary repair, free graft2026 Medicare rate & RVUs

Reports secondary reconstruction of a finger extensor tendon using a free tendon graft, such as for a chronic defect or failed prior repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities48 Medicare services in 2024

Medicare pays $789.26 for 26428 nationally in a facility.

Medicare rate · 26428

Finger tendon repair, secondary repair, free graft

Office or facility?

Work RVUs
7.22
Total RVUs
23.63
Global days
090

National rate · 2026

$789.26

Facility setting, before claim adjustments.

See every locality for 26428 →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 26428 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 26428 covers

This service reconstructs a finger extensor tendon during a secondary operation, using a free tendon graft to bridge or reinforce the tendon defect. A hand or orthopedic surgeon may perform it for a chronic tendon injury or when a prior repair has failed and the tendon cannot be restored adequately by direct repair. The operation is typically performed in a surgical setting and involves preparing the damaged tendon ends, positioning the graft, and securing the reconstruction.

Select the code when the operative report supports a secondary finger extensor tendon repair with a free graft; distinguish it from a repair without graft and from primary repair. Document the digit and tendon, why secondary reconstruction was needed, and the graft used and how it was incorporated. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. 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 26428 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

26428 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$705.06
AlaskaUnavailable$919.37
ArizonaUnavailable$766.53
ArkansasUnavailable$694.52
Atlanta, GAUnavailable$808.15
Austin, TXUnavailable$812.80
Bakersfield, CAUnavailable$821.74
Baltimore area, MDUnavailable$841.46
Beaumont, TXUnavailable$740.90
Brazoria, TXUnavailable$775.55

26428 rates by state

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

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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
26428 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 26428 rate is calculated

Each of 26428’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 · 26428

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.22

7.22 RVUs× 1.000 GPCI

Practice expense14.89

14.89 RVUs× 1.000 GPCI

Malpractice1.52

1.52 RVUs× 1.000 GPCI

Adjusted RVUs

23.6300

Conversion factor

$33.4009

Medicare rate

$789.26

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

Payment rules and modifiers for 26428

26428 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26428

Finger tendon repair, secondary repair, free graft

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 · 26428

Finger tendon repair, secondary repair, 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.

  • 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

26428 without 51 · national facility

$789.26

Finger tendon repair, secondary repair, free graft

26428-51 · Second procedure: 50%

$394.63

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

26428 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26428

    Finger tendon repair, secondary repair, free graft7.22 wRVU

    Not priced

  • 26426

    Tendon repair, secondary, without free graft6.16 wRVU

    Not priced

  • 26420

    Tendon repair, finger, with free graft6.77 wRVU

    Not priced

  • 26418

    Finger tendon repair, without free graft4.36 wRVU

    Not priced

How to choose

26426Tendon repairSecondary, without free graft
Both describe secondary finger extensor tendon repair; 26428 is the graft-based reconstruction, while 26426 is the corresponding repair without a free graft.
26420Tendon repairFinger, with free graft
Both involve a free graft for finger extensor tendon repair. Confirm the specific primary or secondary repair circumstance documented for the procedure before selecting between them.
26418Finger tendon repairWithout free graft
This is finger extensor tendon repair without a free graft. Choose 26428 when the secondary reconstruction uses a free graft.

Codes related to 26428

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

Codes related to 26428
CodeHow it relatesNational office range
Same family
26426Tendon repair, secondary, without free graftSecondary finger extensor tendon repair without the free graft represented by 26428.No office rate
26420Tendon repair, finger, with free graftFinger extensor tendon repair with a free graft; distinguish by the repair circumstances in the operative report.No office rate
26418Finger tendon repair, without free graftFinger extensor tendon repair without a free graft.No office rate
Used instead
26410Hand tendon repair, extensor tendon, without graftExtensor tendon repair for the hand rather than a finger tendon.No office rate

26428 billing questions

Does the code describe primary or secondary repair?

It describes secondary repair. Documentation should establish the secondary nature of the reconstruction, such as a chronic defect or a failed prior repair, rather than simply describing a tendon injury.

Is modifier 50 appropriate when both hands are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.

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 26428PPRRVU2026_Oct_nonQPP.csv, line 2,592 (RVU26D)

Open CMS sourceHow we calculate rates

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