CPT code 26478: Tendon lengthening, hand tendon2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $655.02 for 26478 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 26478 nationwide

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

What 26478 covers

This procedure surgically increases the length of a hand tendon, such as when a shortened or contracted tendon restricts motion or holds a digit in an abnormal position. An orthopedic hand surgeon or plastic surgeon typically performs it in an operating room, often in a hospital or ambulatory surgery center. The operative note should identify the tendon and site, describe the lengthening performed, and explain the functional problem being treated.

Report the code for the documented hand tendon lengthening, not for tendon release, shortening, or transfer. The service has a 90-day global period, which includes 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 other procedures are subject to the standard reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment 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 Puerto Rico compares for 26478

Across 109 of 109 payment localities, the facility rate for 26478 runs from $573.62 in Arkansas to $839.98 in San Benito County, CA. Puerto Rico pays $655.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

26478 rates by state

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

See 26478 in every payment locality

How the 26478 rate is calculated

Each of 26478’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 26478

26478 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

Codes related to 26478

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

How 26478 has changed in Puerto Rico

Price 26478 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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