CPT code 26428: Finger tendon repair, secondary repair, free graft2026 Medicare rate & RVUs in Guam
Reports secondary reconstruction of a finger extensor tendon using a free tendon graft, such as for a chronic defect or failed prior repair.
CMS doesn’t publish an office rate for 26428 in Guam.
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 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.
26428 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $836.02 |
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
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
| 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 · 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.
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%).
26428 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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