CPT code 26437: Tendon realignment, hand or finger extensor2026 Medicare rate & RVUs

Medicare pays $649.65 for 26437 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 26437 covers

A hand surgeon repositions an extensor tendon in the hand or finger so it follows its intended path, such as when it shifts off track near a finger joint. The operation may include stabilizing the tendon in its corrected position. This is a distinct goal from repairing a torn tendon, releasing a contracted tendon, or changing tendon length. It is generally performed in an operating-room setting by an orthopedic or plastic surgeon with hand-surgery expertise.

Report the service for each tendon realigned, with the operative note identifying the tendon, site, abnormal tracking, and corrective work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the treated side rather than using modifier 50. Medicare does not pay an assistant at surgery for this service; 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 26437 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

26437 rates by state

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

How the 26437 rate is calculated

Each of 26437’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.

Payment rules and modifiers for 26437

26437 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

26437 compared with similar codes

How to choose

26410Hand tendon repairExtensor tendon, without graft

26437 repositions an extensor tendon that is tracking abnormally; 26410 describes repair of a hand tendon injury or defect.

26440Flexor tenolysisPalm and finger

26437 corrects tendon alignment. Choose 26440 when the procedure releases a restricted tendon rather than repositioning it.

26476Tendon lengtheningHand or finger

26476 is for lengthening a tendon. It is not the realignment service when the problem is the tendon’s path rather than its length.

26477Tendon shorteningHand or finger, each tendon

26477 addresses tendon shortening. Use 26437 when the operative work restores tendon tracking without shortening it.

Codes related to 26437

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

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

Open CMS sourceHow we calculate rates