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CPT code 26476: Tendon lengthening, hand or finger2026 Medicare rate & RVUs

Reports surgical lengthening of a hand or finger tendon when the surgeon increases tendon length to address restricted motion or abnormal tension.

CMS RVU26DEffective Oct 1, 2026109 payment localities96 Medicare services in 2024

Medicare pays $648.31 for 26476 nationally in a facility.

Medicare rate · 26476

Tendon lengthening, hand or finger

Office or facility?

Work RVUs
5.22
Total RVUs
19.41
Global days
090

National rate · 2026

$648.31

Facility setting, before claim adjustments.

See every locality for 26476 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 26476 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26476 covers

A hand surgeon lengthens a tendon in the hand or finger to change its tension and improve motion or correct a tendon-related deformity. The procedure may be part of operative treatment for a contracture or an imbalance affecting finger position. It is generally performed in an operating room, with the surgeon identifying the tendon and documenting the operative changes made to it.

Report the code for each tendon treated, and document the tendon, hand or finger involved, the clinical problem, and the lengthening performed. This major procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for it; 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 26476 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

26476 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$577.51
AlaskaUnavailable$747.07
ArizonaUnavailable$629.39
ArkansasUnavailable$568.61
Atlanta, GAUnavailable$663.34
Austin, TXUnavailable$669.72
Bakersfield, CAUnavailable$678.91
Baltimore area, MDUnavailable$691.84
Beaumont, TXUnavailable$606.37
Brazoria, TXUnavailable$637.55

26476 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
26476 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

How the 26476 rate is calculated

Each of 26476’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 · 26476

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.22

5.22 RVUs× 1.000 GPCI

Practice expense13.07

13.07 RVUs× 1.000 GPCI

Malpractice1.12

1.12 RVUs× 1.000 GPCI

Adjusted RVUs

19.4100

Conversion factor

$33.4009

Medicare rate

$648.31

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

Payment rules and modifiers for 26476

26476 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26476

Tendon lengthening, hand or finger

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 · 26476

Tendon lengthening, hand or 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.

  • 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

26476 without 51 · national facility

$648.31

Tendon lengthening, hand or finger

26476-51 · Second procedure: 50%

$324.16

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

26476 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26476

    Tendon lengthening, hand or finger5.22 wRVU

    Not priced

  • 26477

    Tendon shortening, hand or finger, each tendon5.19 wRVU

    Not priced

  • 26478

    Tendon lengthening, hand tendon5.82 wRVU

    Not priced

  • 26440

    Flexor tenolysis, palm and finger5.03 wRVU

    Not priced

How to choose

26477Tendon shorteningHand or finger, each tendon
Choose 26476 when the surgeon lengthens a hand or finger tendon; choose 26477 when the operative work shortens it.
26478Tendon lengtheningHand tendon
Both codes concern tendon lengthening in the hand region. Use the full CPT descriptors and documented tendon and anatomic scope to distinguish them.
26440Flexor tenolysisPalm and finger
26440 describes tendon release in the palm or finger, while 26476 describes lengthening a tendon. The operative work, not the general goal of improved motion, determines the code.

Codes related to 26476

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

Codes related to 26476
CodeHow it relatesNational office range
Same family
26477Tendon shortening, hand or finger, each tendonTendon shortening is the opposite operative change in the related hand and finger tendon code series.No office rate
26478Tendon lengthening, hand tendonAnother hand tendon lengthening code; check the full descriptor to determine the applicable scope.No office rate
26479Tendon shortening, hand or finger extensorA hand tendon shortening code in the neighboring lengthening and shortening series.No office rate
Used instead
26440Flexor tenolysis, palm and fingerTendon release is a different approach when the operative goal is releasing rather than lengthening a tendon.No office rate
26480Tendon transfer, dorsal hand, no free graftTendon transplantation changes tendon routing or function rather than lengthening the treated tendon.No office rate

26476 billing questions

When should this code be chosen instead of tendon shortening?

Use this code when the operative work lengthens the hand or finger tendon. Tendon shortening is the counterpart when the surgeon reduces tendon length.

How many units should be reported?

Report the service for each tendon lengthened. The operative report should identify each tendon treated and the work performed.

Is postoperative care separately reported during the global period?

Related postoperative care for 90 days is included, as is the day-before preoperative visit. The global period begins with the major surgery.

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.

Can an assistant surgeon or co-surgeon be reported?

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

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the 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
RVUs for 26476PPRRVU2026_Oct_nonQPP.csv, line 2,606 (RVU26D)

Open CMS sourceHow we calculate rates

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