CPT code 26437: Tendon realignment, hand or finger extensor2026 Medicare rate & RVUs in Nevada
Reports surgical repositioning of a hand or finger extensor tendon when its course is abnormal and realignment is needed to restore tracking.
In Nevada, Medicare pays $643.82 for 26437 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 26437 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Nevada compares for 26437
Across 109 of 109 payment localities, the facility rate for 26437 runs from $572.68 in Arkansas to $838.14 in San Benito County, CA. Nevada pays $643.82. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$643.82
- Los Angeles, CA · California$721.42+$77.60
- Washington, DC area · District of Columbia$738.67+$94.85
- Miami, FL · Florida$723.95+$80.13
- Chicago, IL · Illinois$701.54+$57.72
- Manhattan, NY · New York$751.64+$107.82
- Alaska · Alaska$757.50+$113.68
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $581.26 |
| ArkansasArkansas | — | $572.68 |
| ArizonaArizona | — | $631.33 |
| Bakersfield, CACalifornia | — | $678.78 |
| Chico, CACalifornia | — | $675.65 |
| El Centro, CACalifornia | — | $675.84 |
| Fresno, CACalifornia | — | $675.65 |
| Hanford, CACalifornia | — | $675.65 |
| Madera, CACalifornia | — | $675.65 |
| Merced, CACalifornia | — | $675.65 |
| Modesto, CACalifornia | — | $675.65 |
| Napa, CACalifornia | — | $776.19 |
| Oxnard, CACalifornia | — | $716.93 |
| Redding, CACalifornia | — | $675.65 |
| Rest of CaliforniaCalifornia | — | $675.65 |
| Riverside, CACalifornia | — | $687.71 |
| Sacramento, CACalifornia | — | $707.31 |
| Salinas, CACalifornia | — | $704.67 |
| San Diego, CACalifornia | — | $720.13 |
| Marin County, CACalifornia | — | $818.98 |
| San Francisco, CACalifornia | — | $817.71 |
| San Benito County, CACalifornia | — | $838.14 |
| Santa Clara County, CACalifornia | — | $832.94 |
| San Luis Obispo, CACalifornia | — | $693.59 |
| Santa Cruz, CACalifornia | — | $726.08 |
| Santa Maria, CACalifornia | — | $707.00 |
| Santa Rosa, CACalifornia | — | $733.26 |
| Stockton, CACalifornia | — | $675.65 |
| Vallejo, CACalifornia | — | $774.36 |
| Visalia, CACalifornia | — | $675.65 |
| Yuba City, CACalifornia | — | $675.65 |
| ColoradoColorado | — | $670.50 |
| ConnecticutConnecticut | — | $693.53 |
| DelawareDelaware | — | $641.84 |
| Fort Lauderdale, FLFlorida | — | $685.30 |
| Rest of FloridaFlorida | — | $650.11 |
| Atlanta, GAGeorgia | — | $664.43 |
| Rest of GeorgiaGeorgia | — | $611.77 |
| Hawaii, Guam, HIHawaii | — | $691.05 |
| IowaIowa | — | $591.63 |
| IdahoIdaho | — | $596.56 |
| East St. Louis, ILIllinois | — | $654.21 |
| Rest of IllinoisIllinois | — | $634.41 |
| Suburban Chicago, ILIllinois | — | $691.16 |
| IndianaIndiana | — | $599.97 |
| KansasKansas | — | $591.04 |
| KentuckyKentucky | — | $600.16 |
| New Orleans, LALouisiana | — | $630.12 |
| Rest of LouisianaLouisiana | — | $600.10 |
| Metropolitan Boston, MAMassachusetts | — | $734.46 |
| Rest of MassachusettsMassachusetts | — | $667.28 |
| Baltimore area, MDMaryland | — | $692.09 |
| Rest of MarylandMaryland | — | $653.54 |
| Rest of MaineMaine | — | $602.13 |
| Southern Maine, MEMaine | — | $632.09 |
| Detroit, MIMichigan | — | $660.71 |
| Rest of MichiganMichigan | — | $618.18 |
| MinnesotaMinnesota | — | $635.41 |
| Metropolitan Kansas City, MOMissouri | — | $623.34 |
| Metropolitan St. Louis, MOMissouri | — | $629.70 |
| Rest of MissouriMissouri | — | $591.10 |
| MississippiMississippi | — | $581.90 |
| MontanaMontana | — | $649.57 |
| North CarolinaNorth Carolina | — | $608.19 |
| North DakotaNorth Dakota | — | $627.43 |
| NebraskaNebraska | — | $594.26 |
| New HampshireNew Hampshire | — | $662.08 |
| Northern New JerseyNew Jersey | — | $731.23 |
| Rest of New JerseyNew Jersey | — | $699.46 |
| New MexicoNew Mexico | — | $622.54 |
| NYC suburbs and Long Island, NYNew York | — | $773.04 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $705.91 |
| Queens, NYNew York | — | $754.59 |
| Rest of New YorkNew York | — | $617.68 |
| OhioOhio | — | $613.65 |
| OklahomaOklahoma | — | $596.67 |
| Portland, OROregon | — | $689.50 |
| Rest of OregonOregon | — | $636.87 |
| Metropolitan Philadelphia, PAPennsylvania | — | $677.48 |
| Rest of PennsylvaniaPennsylvania | — | $613.38 |
| Puerto RicoPuerto Rico | — | $653.68 |
| Rhode IslandRhode Island | — | $663.08 |
| South CarolinaSouth Carolina | — | $612.33 |
| South DakotaSouth Dakota | — | $624.81 |
| TennesseeTennessee | — | $594.36 |
| Austin, TXTexas | — | $669.97 |
| Beaumont, TXTexas | — | $609.45 |
| Brazoria, TXTexas | — | $639.22 |
| Dallas, TXTexas | — | $644.42 |
| Fort Worth, TXTexas | — | $640.74 |
| Galveston, TXTexas | — | $641.85 |
| Houston, TXTexas | — | $662.35 |
| Rest of TexasTexas | — | $624.74 |
| UtahUtah | — | $620.80 |
| VirginiaVirginia | — | $631.56 |
| Virgin Islands, VIUnited States Virgin Islands | — | $653.68 |
| VermontVermont | — | $627.00 |
| Rest of WashingtonWashington | — | $665.35 |
| King County, WAWashington | — | $747.25 |
| WisconsinWisconsin | — | $606.24 |
| West VirginiaWest Virginia | — | $611.12 |
| WyomingWyoming | — | $639.92 |
26437 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 26437
RVUs × geographic indexes × conversion factor
Work5.84
5.84 RVUs× 1.000 GPCI
Practice expense12.49
12.49 RVUs× 1.000 GPCI
Malpractice1.12
1.12 RVUs× 1.000 GPCI
Adjusted RVUs
19.4500
Conversion factor
$33.4009
Medicare rate
$649.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,596
- Code
- 26437
- Physician work
- 5.84
- Practice expense
- 12.49
- Malpractice
- 1.12
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.84 | × 1.000 | 5.8400 |
| Practice expense | 12.49 | × 1.001 | 12.5025 |
| Malpractice | 1.12 | × 0.833 | 0.9330 |
| Total RVUs | 19.2754 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada$643.82
Facility: (5.84 × 1 + 12.49 × 1.001 + 1.12 × 0.833) × $33.4009 = $643.82
Payment rules and modifiers for 26437
26437 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26437
Tendon realignment, hand or finger extensor
| 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 · 26437
Tendon realignment, hand or finger extensor
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
26437 without 51 · national facility
$649.65
Tendon realignment, hand or finger extensor
26437-51 · Second procedure: 50%
$324.83
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%).
How 26437 has changed in Nevada
26437 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $643.82 | RVU26D |
| 2026-07-01 | Not available in this setting | $643.82 | RVU26C |
| 2026-04-01 | Not available in this setting | $643.82 | RVU26B |
| 2026-01-01 | Not available in this setting | $643.82 | RVU26A |
| 2025-10-01 | Not available in this setting | $648.67 | RVU25D |
| 2025-07-01 | Not available in this setting | $648.67 | RVU25C |
| 2025-04-01 | Not available in this setting | $648.67 | RVU25B |
| 2025-01-01 | Not available in this setting | $648.67 | RVU25A |
| 2024-10-01 | Not available in this setting | $669.82 | RVU24D |
| 2024-07-01 | Not available in this setting | $669.82 | RVU24C |
| 2024-04-01 | Not available in this setting | $669.82 | RVU24B |
| 2024-03-09 | Not available in this setting | $669.82 | RVU24AR |
| 2024-01-01 | Not available in this setting | $658.88 | RVU24A |
| 2023-10-01 | Not available in this setting | $692.99 | RVU23D |
| 2023-07-01 | Not available in this setting | $692.99 | RVU23C |
| 2023-04-01 | Not available in this setting | $692.99 | RVU23B |
| 2023-01-01 | Not available in this setting | $692.99 | RVU23A |
| 2022-10-01 | Not available in this setting | $714.60 | RVU22D |
| 2022-07-01 | Not available in this setting | $714.60 | RVU22C |
| 2022-04-01 | Not available in this setting | $714.60 | RVU22B |
| 2022-01-01 | Not available in this setting | $714.60 | RVU22A |
| 2021-10-01 | Not available in this setting | $705.40 | RVU21D |
| 2021-07-01 | Not available in this setting | $705.40 | RVU21C |
| 2021-04-01 | Not available in this setting | $705.40 | RVU21B |
| 2021-01-01 | Not available in this setting | $705.40 | RVU21A |
| 2020-10-01 | Not available in this setting | $666.32 | RVU20D |
| 2020-07-01 | Not available in this setting | $666.32 | RVU20C |
| 2020-04-01 | Not available in this setting | $666.32 | RVU20B |
| 2020-01-01 | Not available in this setting | $666.32 | RVU20A |
| 2019-10-01 | Not available in this setting | $636.45 | RVU19D |
| 2019-07-01 | Not available in this setting | $636.45 | RVU19C |
| 2019-04-01 | Not available in this setting | $636.45 | RVU19B |
| 2019-01-01 | Not available in this setting | $636.45 | RVU19A |
| 2018-10-01 | Not available in this setting | $638.72 | RVU18D |
| 2018-07-01 | Not available in this setting | $638.72 | RVU18C |
| 2018-04-01 | Not available in this setting | $638.72 | RVU18B |
| 2018-01-01 | Not available in this setting | $638.72 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $641.37 | RVU17D |
| 2017-07-01 | Not available in this setting | $641.37 | RVU17C |
| 2017-04-01 | Not available in this setting | $641.37 | RVU17B |
| 2017-01-01 | Not available in this setting | $641.37 | RVU17A |
| 2016-10-01 | Not available in this setting | $646.68 | RVU16D |
| 2016-07-01 | Not available in this setting | $646.68 | RVU16C |
| 2016-04-01 | Not available in this setting | $646.68 | RVU16B |
| 2016-01-01 | Not available in this setting | $646.68 | RVU16A |
| 2015-10-01 | Not available in this setting | $649.39 | RVU15D |
| 2015-07-01 | Not available in this setting | $649.39 | RVU15C |
| 2015-04-01 | Not available in this setting | $646.16 | RVU15B |
| 2015-01-01 | Not available in this setting | $646.16 | RVU15A |
| 2014-10-01 | Not available in this setting | $643.70 | RVU14D |
| 2014-07-01 | Not available in this setting | $643.70 | RVU14C |
| 2014-04-01 | Not available in this setting | $643.70 | RVU14B |
| 2014-01-01 | Not available in this setting | $643.70 | RVU14A |
| 2013-10-01 | Not available in this setting | $656.97 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
26437 billing questions
When should I report realignment rather than tendon repair?
Use 26437 when the operative objective is to reposition an extensor tendon onto its intended path. A tendon defect or tear repaired with sutures is a different service, such as the hand tendon repair represented by 26410.
Is this reported for each tendon?
Yes. The code is reported per tendon realigned; the operative note should identify each tendon and describe the correction.
Should modifier 50 be used for both hands?
No. The CMS bilateral adjustment is inappropriate for this code. Report the actual operative side and documented tendon work.
Can an assistant surgeon be billed?
Medicare's statutory restriction bars assistant-at-surgery payment for this service. Co-surgeon and team-surgery billing are also not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The same-session multiple-procedure reduction may affect payment when other procedures are performed.
What documentation supports 26437?
Document the tendon and hand or finger site, the abnormal tendon course or tracking, and the operative steps that reposition it. The record should distinguish realignment from repair, release, or lengthening.
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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