CPT code 26440: Flexor tenolysis, palm and finger2026 Medicare rate & RVUs in Illinois
Surgical release of adhesions limiting flexor tendon glide in the palm or finger, reported for each tendon treated.
CMS doesn’t publish an office rate for 26440 in Illinois.
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 26440 covers
This operation frees a flexor tendon from scar tissue that restricts its movement through the palm or finger. A hand surgeon typically performs it when adhesions remain after a tendon injury or repair and limit active motion. The surgeon exposes the involved tendon and releases the surrounding scar while preserving the tendon and nearby structures. The service may be performed in a hospital or ambulatory surgery setting.
Report the code for each flexor tendon released in the palm and finger, and document the tendon, site, adhesions, and release performed. Use the more extensive-dissection sibling when the operative work meets that distinction. Medicare assigns 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 others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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 26440 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $687.55 |
| East St. Louis, IL | Unavailable | $639.74 |
| Rest of Illinois | Unavailable | $622.18 |
| Suburban Chicago, IL | Unavailable | $680.51 |
How the 26440 rate is calculated
Each of 26440’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 · 26440
RVUs × geographic indexes × conversion factor
Work5.03
5.03 RVUs× 1.000 GPCI
Practice expense13.25
13.25 RVUs× 1.000 GPCI
Malpractice0.96
0.96 RVUs× 1.000 GPCI
Adjusted RVUs
19.2400
Conversion factor
$33.4009
Medicare rate
$642.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26440
26440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26440
Flexor tenolysis, palm and finger
| 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 · 26440
Flexor tenolysis, palm and finger
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
26440 without 51 · national facility
$642.63
Flexor tenolysis, palm and finger
26440-51 · Second procedure: 50%
$321.32
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%).
26440 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26442Flexor tenolysisPalm and finger, with free graft
- This code covers flexor tenolysis in the palm and finger without the extensive-dissection distinction. Choose 26442 when the operative work meets that sibling code's extensive-dissection criterion.
- 26445Tendon releaseExtensor, hand or finger
- This code is for extensor tendon tenolysis in the hand or finger. Code 26440 concerns flexor tendon adhesions in the palm and finger.
- 26449Tendon releaseExtensor tendon, forearm or wrist
- This code addresses flexor tendon tenolysis at the forearm or wrist. Choose 26440 for the palm and finger site.
- 26410Hand tendon repairExtensor tendon, without graft
- This code repairs a hand tendon; 26440 releases adhesions restricting a tendon that is already present. The operative purpose, not simply a history of tendon injury, distinguishes them.
26440 billing questions
How is this code distinguished from 26442?
Both describe flexor tendon adhesion release in the palm and finger. Use 26442 when the operative work requires the extensive dissection specified for that sibling code.
Is the code reported once per hand or once per tendon?
It is reported for each tendon released. The operative note should identify each treated tendon and its location.
Can modifier 50 be used when both hands are treated?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Are related postoperative visits included?
Yes. The 90-day global period includes related postoperative care and the day-before preoperative visit.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens when this is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures 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
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