CPT code 26497: Tendon transfer, finger flexor tendon2026 Medicare rate & RVUs in California
Reports transfer of a flexor tendon in a finger to restore useful movement when the original tendon function is impaired.
CMS doesn’t publish an office rate for 26497 in California.
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 26497 covers
A hand surgeon transfers a flexor tendon to restore or improve finger movement when the existing tendon cannot provide adequate function. The operation redirects tendon force to a recipient attachment; the specific donor tendon, recipient finger, and functional problem depend on the reconstruction. It is typically performed in an operating room by an orthopedic or plastic surgeon specializing in hand surgery.
Report this code for the finger flexor tendon transfer itself, not for tendon release or lengthening alone. The operative report should identify the transferred tendon, recipient site, finger, and reason for redirecting its pull. The 90-day global period includes the day-before preoperative visit and related postoperative care. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; 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 26497 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $906.57 |
| Chico, CA | Unavailable | $900.96 |
| El Centro, CA | Unavailable | $901.30 |
| Fresno, CA | Unavailable | $900.96 |
| Hanford, CA | Unavailable | $900.96 |
| Los Angeles, CA | Unavailable | $960.26 |
| Madera, CA | Unavailable | $900.96 |
| Marin County, CA | Unavailable | $1,075.53 |
| Merced, CA | Unavailable | $900.96 |
| Modesto, CA | Unavailable | $900.96 |
| Napa, CA | Unavailable | $1,023.27 |
| Oxnard, CA | Unavailable | $952.84 |
| Redding, CA | Unavailable | $900.96 |
| Rest of California | Unavailable | $900.96 |
| Riverside, CA | Unavailable | $922.88 |
| Sacramento, CA | Unavailable | $940.08 |
| Salinas, CA | Unavailable | $936.51 |
| San Benito County, CA | Unavailable | $1,101.34 |
| San Diego, CA | Unavailable | $954.87 |
| San Francisco, CA | Unavailable | $1,073.21 |
| San Luis Obispo, CA | Unavailable | $922.19 |
| Santa Clara County, CA | Unavailable | $1,091.87 |
| Santa Cruz, CA | Unavailable | $960.98 |
| Santa Maria, CA | Unavailable | $939.02 |
| Santa Rosa, CA | Unavailable | $970.26 |
| Stockton, CA | Unavailable | $900.96 |
| Vallejo, CA | Unavailable | $1,019.94 |
| Visalia, CA | Unavailable | $900.96 |
| Yuba City, CA | Unavailable | $900.96 |
How the 26497 rate is calculated
Each of 26497’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 · 26497
RVUs × geographic indexes × conversion factor
Work9.52
9.52 RVUs× 1.000 GPCI
Practice expense14.78
14.78 RVUs× 1.000 GPCI
Malpractice2.04
2.04 RVUs× 1.000 GPCI
Adjusted RVUs
26.3400
Conversion factor
$33.4009
Medicare rate
$879.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26497
26497 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26497
Tendon transfer, finger flexor tendon
| 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) | 2 | Paid. |
| 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 · 26497
Tendon transfer, finger flexor tendon
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
26497 without 51 · national facility
$879.78
Tendon transfer, finger flexor tendon
26497-51 · Second procedure: 50%
$439.89
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%).
26497 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26498Tendon transferFinger flexor tendon
- Use 26497 for transfer of a finger flexor tendon; 26498 describes the corresponding transfer involving a finger extensor tendon.
- 26494Tendon transferHand tendon or muscle
- 26494 covers a hand tendon or muscle transfer. Choose 26497 when the transferred structure and operative work are specifically a finger flexor tendon transfer.
- 26492Tendon transferThumb with free tendon graft
- 26492 concerns a thumb tendon transfer with a graft. It is not the code for a finger flexor tendon transfer.
- 26440Flexor tenolysisPalm and finger
- 26440 is a flexor tendon release for adhesions in the palm or finger. It does not describe transferring the tendon to redirect its pull.
26497 billing questions
How does 26497 differ from 26498?
26497 is for transfer of a finger flexor tendon. 26498 is the corresponding finger extensor tendon transfer.
Can 26497 be reported for tendon release or lengthening?
No. The procedure must redirect a flexor tendon to a new attachment; release and lengthening describe different work.
What should the operative report document?
Identify the donor tendon, recipient attachment, finger treated, and functional problem prompting the transfer. The documentation should make clear that a transfer was performed rather than an isolated release or lengthening.
Should modifier 50 be used for bilateral finger transfers?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment may be made. 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
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