CPT code 26442: Flexor tenolysis, palm and finger, with free graft2026 Medicare rate & RVUs in Minnesota

Reports secondary release of adhesions limiting flexor tendon glide in the palm or finger when the procedure includes a free tendon graft.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Minnesota, Medicare pays $934.55 for 26442 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$934.55Hospital or facility

Check a contract rate as a % of Medicare · 26442 nationwide

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

We’ll open 26442 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Minnesota
  2. What 26442 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 26442 covers

This procedure addresses a flexor tendon in the palm or finger that remains tethered by scar tissue and cannot glide adequately, often after an earlier tendon injury or repair. The surgeon frees the tendon and uses a free tendon graft as part of the secondary reconstruction. Hand surgeons typically perform it in an operating room, with the operative report identifying the involved tendon, adhesion release, and graft work.

Report 26442 for the secondary flexor tenolysis with free graft; 26440 is the related choice for flexor tenolysis without that graft work. The record should support the affected tendon, the adhesions restricting excursion, and the graft used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 Minnesota compares for 26442

Across 109 of 109 payment localities, the facility rate for 26442 runs from $849.10 in Arkansas to $1,224.54 in San Benito County, CA. Minnesota pays $934.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

26442 in Minnesota vs other payment areas
  1. Minnesota · this page$934.55
  2. Los Angeles, CA · California$1,059.79+$125.24
  3. Washington, DC area · District of Columbia$1,088.61+$154.06
  4. Miami, FL · Florida$1,078.77+$144.22
  5. Chicago, IL · Illinois$1,045.66+$111.11
  6. Manhattan, NY · New York$1,111.55+$177.00
  7. Alaska · Alaska$1,129.99+$195.44

Other areas in Minnesota first, then benchmark localities. Bars start at $0.

Every other payment area

26442 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$861.54
ArkansasArkansas—$849.10
ArizonaArizona—$934.06
Bakersfield, CACalifornia—$998.81
Chico, CACalifornia—$993.68
El Centro, CACalifornia—$993.99
Fresno, CACalifornia—$993.68
Hanford, CACalifornia—$993.68

26442 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
26442 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

See 26442 in every payment locality

How the 26442 rate is calculated

Each of 26442’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 · 26442

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.51

9.51 RVUs× 1.000 GPCI

Practice expense17.42

17.42 RVUs× 1.000 GPCI

Malpractice1.84

1.84 RVUs× 1.000 GPCI

Adjusted RVUs

28.7700

Conversion factor

$33.4009

Medicare rate

$960.94

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

The exact Minnesota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,598

Code
26442
Physician work
9.51
Practice expense
17.42
Malpractice
1.84

GPCI2026.csv

66

Locality
Minnesota
Physician work
1.000
Practice expense
1.029
Malpractice
0.296
Facility calculation for 26442 in Minnesota
ComponentRVULocality factorAdjusted
Physician work9.51× 1.0009.5100
Practice expense17.42× 1.02917.9252
Malpractice1.84× 0.2960.5446
Total RVUs27.9798
Conversion factor× 33.4009

Facility rate, Minnesota$934.55

Facility: (9.51 × 1 + 17.42 × 1.029 + 1.84 × 0.296) × $33.4009 = $934.55

Open 26442 in the RVU calculator

Payment rules and modifiers for 26442

26442 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26442

Flexor tenolysis, palm and finger, with 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)1Not paid (statutory restriction).
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 · 26442

Flexor tenolysis, palm and finger, with 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

26442 without 51 · national facility

$960.94

Flexor tenolysis, palm and finger, with free graft

26442-51 · Second procedure: 50%

$480.47

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

How 26442 has changed in Minnesota

26442 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$934.55RVU26D
2026-07-01Not available in this setting$934.55RVU26C
2026-04-01Not available in this setting$934.55RVU26B
2026-01-01Not available in this setting$934.55RVU26A
2025-10-01Not available in this setting$945.94RVU25D
2025-07-01Not available in this setting$945.94RVU25C
2025-04-01Not available in this setting$945.94RVU25B
2025-01-01Not available in this setting$945.94RVU25A
2024-10-01Not available in this setting$973.70RVU24D
2024-07-01Not available in this setting$973.70RVU24C
2024-04-01Not available in this setting$973.70RVU24B
2024-03-09Not available in this setting$973.70RVU24AR
2024-01-01Not available in this setting$957.81RVU24A
2023-10-01Not available in this setting$990.16RVU23D
2023-07-01Not available in this setting$990.16RVU23C
2023-04-01Not available in this setting$990.16RVU23B
2023-01-01Not available in this setting$990.16RVU23A
2022-10-01Not available in this setting$1,001.03RVU22D
2022-07-01Not available in this setting$1,001.03RVU22C
2022-04-01Not available in this setting$1,001.03RVU22B
2022-01-01Not available in this setting$1,001.03RVU22A
2021-10-01Not available in this setting$997.86RVU21D
2021-07-01Not available in this setting$997.86RVU21C
2021-04-01Not available in this setting$997.86RVU21B
2021-01-01Not available in this setting$997.86RVU21A
2020-10-01Not available in this setting$969.83RVU20D
2020-07-01Not available in this setting$969.83RVU20C
2020-04-01Not available in this setting$969.83RVU20B
2020-01-01Not available in this setting$969.83RVU20A
2019-10-01Not available in this setting$945.76RVU19D
2019-07-01Not available in this setting$945.76RVU19C
2019-04-01Not available in this setting$945.76RVU19B
2019-01-01Not available in this setting$945.76RVU19A
2018-10-01Not available in this setting$951.40RVU18D
2018-07-01Not available in this setting$951.40RVU18C
2018-04-01Not available in this setting$951.40RVU18B
2018-01-01Not available in this setting$951.40RVU18AR1
2017-10-01Not available in this setting$946.23RVU17D
2017-07-01Not available in this setting$946.23RVU17C
2017-04-01Not available in this setting$946.23RVU17B
2017-01-01Not available in this setting$946.23RVU17A
2016-10-01Not available in this setting$940.60RVU16D
2016-07-01Not available in this setting$940.60RVU16C
2016-04-01Not available in this setting$940.60RVU16B
2016-01-01Not available in this setting$940.60RVU16A
2015-10-01Not available in this setting$944.73RVU15D
2015-07-01Not available in this setting$944.73RVU15C
2015-04-01Not available in this setting$940.03RVU15B
2015-01-01Not available in this setting$940.03RVU15A
2014-10-01Not available in this setting$931.31RVU14D
2014-07-01Not available in this setting$931.31RVU14C
2014-04-01Not available in this setting$931.31RVU14B
2014-01-01Not available in this setting$931.31RVU14A
2013-10-01Not available in this setting$936.16RVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 26442 for an earlier date of service

Where the Minnesota rate applies

Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.

  • Ada
  • Adams
  • Adrian
  • Afton
  • Aitkin
  • Akeley
  • Albany
  • Albert Lea

Browse all communities in Minnesota

26442 billing questions

How does 26442 differ from 26440?

Both concern flexor tendon tenolysis in the palm and finger. Use 26442 for the secondary procedure with a free tendon graft; use 26440 for tenolysis without that graft work.

Is the free tendon graft separately reported?

The graft is part of the service described by 26442. Document the graft and its role in the secondary tendon procedure.

Can modifier 50 be used for procedures on both hands?

No. CMS identifies modifier 50 as inappropriate for this code.

What postoperative care is included?

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

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Is an assistant surgeon or co-surgeon payable?

Medicare does not pay an assistant at surgery for 26442. Co-surgeons and team surgery are not permitted.

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 26442PPRRVU2026_Oct_nonQPP.csv, line 2,598 (RVU26D)
Geographic factors for MinnesotaGPCI2026.csv, line 66 (RVU26D)

Open CMS sourceHow we calculate rates

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