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CPT code 28226: Tendon release, multiple flexor tendons2026 Medicare rate & RVUs in Washington, DC area

Open tenolysis of multiple foot or toe flexor tendons frees restricted tendon glide when adhesions limit motion after injury or prior surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality83 Medicare services in 2024

In Washington, DC area, Medicare pays $762.81 for 28226 in the office and $439.38 when it’s performed in a hospital or facility.

$762.81Office (non-facility)
$439.38Hospital or facility
+14.6%vs the national office rate ($665.35)

Check a contract rate as a % of Medicare · 28226 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 28226 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28226 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 28226 covers

This procedure surgically frees adhesions restricting the glide of multiple flexor tendons in the foot or toes. An orthopedic or podiatric surgeon typically performs it in an operating room when scar tissue limits tendon excursion, often after prior trauma or surgery. The operative work is directed at freeing the tendons, rather than repairing a tendon rupture or cutting a tendon to correct deformity.

Report the code when the surgeon documents open adhesiolysis involving multiple flexor tendons; the operative note should identify the tendons treated and the adhesion release performed. A release of a single flexor tendon is distinguished by the neighboring single-tendon code. Medicare 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 other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 Washington, DC area compares for 28226

Across 109 of 109 payment localities, the office rate for 28226 runs from $581.70 in Arkansas to $879.32 in San Benito County, CA. Washington, DC area pays $762.81. The RVUs are the same everywhere; the geographic indexes change the dollars.

28226 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$762.81
  2. Los Angeles, CA · California$748.54−$14.27
  3. Miami, FL · Florida$735.10−$27.71
  4. Chicago, IL · Illinois$711.20−$51.61
  5. Manhattan, NY · New York$772.12+$9.31
  6. Alaska · Alaska$757.88−$4.93
  7. Alabama · Alabama$591.06−$171.75

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

28226 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$581.70$345.86
ArizonaArizona$645.73$379.69
Bakersfield, CACalifornia$701.58$400.66
Chico, CACalifornia$698.88$397.97
El Centro, CACalifornia$699.05$398.13
Fresno, CACalifornia$698.88$397.97
Hanford, CACalifornia$698.88$397.97
Madera, CACalifornia$698.88$397.97

28226 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$581.70

$789.10

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28226 office rate range by state
State / territoryOffice rate rangeLocalities
AK$757.881
AL$591.061
AR$581.701
AZ$645.731
CA$698.88–$879.3229
CO$690.761
CT$712.271
DC$762.811
DE$657.031
FL$660.66–$735.103
GA$619.72–$680.072
GU$717.411
HI$717.411
IA$604.751
ID$609.641
IL$641.96–$711.204
IN$613.431
KS$602.971
KY$609.211
LA$608.70–$641.442
MA$686.61–$761.222
MD$669.95–$762.813
ME$614.52–$648.942
MI$627.75–$670.982
MN$656.241
MO$598.17–$642.343
MS$589.991
MT$665.281
NC$621.331
ND$645.901
NE$607.981
NH$680.961
NJ$718.82–$754.052
NM$632.031
NV$660.361
NY$631.59–$793.975
OH$623.791
OK$606.621
OR$653.70–$712.752
PA$624.13–$694.112
PR$670.141
RI$680.561
SC$623.911
SD$643.611
TN$606.451
TX$619.76–$689.808
UT$633.171
VA$647.55–$762.812
VI$670.141
VT$644.371
WA$684.97–$776.062
WI$622.511
WV$616.491
WY$656.841

See 28226 in every payment locality

How the 28226 rate is calculated

Each of 28226’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 · 28226

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.55

4.55 RVUs× 1.000 GPCI

Practice expense14.39

14.39 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

19.9200

Conversion factor

$33.4009

Medicare rate

$665.35

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,154

Code
28226
Physician work
4.55
Practice expense
14.39
Malpractice
0.98

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28226 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work4.55× 1.0544.7957
Practice expense14.39× 1.17816.9514
Malpractice0.98× 1.1131.0907
Total RVUs22.8379
Conversion factor× 33.4009

Office rate, Washington, DC area$762.81

Office: (4.55 × 1.054 + 14.39 × 1.178 + 0.98 × 1.113) × $33.4009 = $762.81

Facility: (4.55 × 1.054 + 6.17 × 1.178 + 0.98 × 1.113) × $33.4009 = $439.38

Open 28226 in the RVU calculator

Payment rules and modifiers for 28226

28226 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28226

Tendon release, multiple flexor tendons

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 28226

Tendon release, multiple flexor tendons

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 50 · payment effect

With and without the modifier

28226 without 50 · national office

$665.35

Tendon release, multiple flexor tendons

28226-50 · Bilateral: 150%

$998.03

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 28226

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

Codes related to 28226
CodeHow it relatesOffice range, Washington, DC area
Same family
28225Tendon release, flexor tendonRelated flexor tendon release for a single tendon rather than multiple tendons.$467.44
28222Tendon release, single extensor tendonRelease of extensor tendon adhesions in the foot or toe rather than flexor tendon adhesions.$615.54
Used instead
28232Toe tendon incision, single flexor tendonOpen flexor tenotomy of a toe when tendon division, rather than adhesiolysis, is performed.$425.78
28200Foot tendon repair, flexor, without free graftFoot flexor tendon repair when the operative service repairs a tendon rather than freeing adhesions.$573.78

How 28226 has changed in Washington, DC area

28226 · Office / nonfacility

$762.81

Effective 2026-10-01

The base rate is $68.71 higher than on 2025-10-01, moving from $694.10 to $762.81 (9.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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

  1. January 1, 2026

    RVU26A

    $694.10changed to$762.81

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.67 changed to 4.55
    • Practice expense RVU 12.93 changed to 14.39
    • Malpractice RVU 0.95 changed to 0.98
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $717.06changed to$694.10

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.98 changed to 12.93
    • Malpractice RVU 0.97 changed to 0.95

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $705.35changed to$717.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $739.08changed to$705.35

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.95 changed to 12.98
    • Malpractice RVU 0.94 changed to 0.97
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $761.25changed to$739.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.81 changed to 12.95
    • Malpractice RVU 0.96 changed to 0.94
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $774.83changed to$761.25

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.01 changed to 12.81
    • Malpractice RVU 0.93 changed to 0.96

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $752.37changed to$774.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.11 changed to 13.01
    • Malpractice RVU 0.91 changed to 0.93
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $743.23changed to$752.37

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.06 changed to 12.11
    • Malpractice RVU 0.96 changed to 0.91
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $742.83changed to$743.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.08 changed to 12.06
    • Malpractice RVU 0.95 changed to 0.96

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $586.83changed to$742.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.16 changed to 12.08
    • Malpractice RVU 0.33 changed to 0.95
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $732.69changed to$586.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.90 changed to 9.16
    • Malpractice RVU 0.95 changed to 0.33
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $526.28changed to$732.69

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.72 changed to 11.90
    • Malpractice RVU 0.34 changed to 0.95

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $523.66changed to$526.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $699.72changed to$523.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.84 changed to 7.72
    • Malpractice RVU 0.33 changed to 0.34
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $715.71changed to$699.72

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.14 changed to 11.84
    • Malpractice RVU 0.35 changed to 0.33
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $715.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$762.81$439.38RVU26D
2026-07-01$762.81$439.38RVU26C
2026-04-01$762.81$439.38RVU26B
2026-01-01$762.81$439.38RVU26A
2025-10-01$694.10$454.66RVU25D
2025-07-01$694.10$454.66RVU25C
2025-04-01$694.10$454.66RVU25B
2025-01-01$694.10$454.66RVU25A
2024-10-01$717.06$463.11RVU24D
2024-07-01$717.06$463.11RVU24C
2024-04-01$717.06$463.11RVU24B
2024-03-09$717.06$463.11RVU24AR
2024-01-01$705.35$455.55RVU24A
2023-10-01$739.08$471.67RVU23D
2023-07-01$739.08$471.67RVU23C
2023-04-01$739.08$471.67RVU23B
2023-01-01$739.08$471.67RVU23A
2022-10-01$761.25$479.38RVU22D
2022-07-01$761.25$479.38RVU22C
2022-04-01$761.25$479.38RVU22B
2022-01-01$761.25$479.38RVU22A
2021-10-01$774.83$478.55RVU21D
2021-07-01$774.83$478.55RVU21C
2021-04-01$774.83$478.55RVU21B
2021-01-01$774.83$478.55RVU21A
2020-10-01$752.37$472.99RVU20D
2020-07-01$752.37$472.99RVU20C
2020-04-01$752.37$472.99RVU20B
2020-01-01$752.37$472.99RVU20A
2019-10-01$743.23$468.34RVU19D
2019-07-01$743.23$468.34RVU19C
2019-04-01$743.23$468.34RVU19B
2019-01-01$743.23$468.34RVU19A
2018-10-01$742.83$467.37RVU18D
2018-07-01$742.83$467.37RVU18C
2018-04-01$742.83$467.37RVU18B
2018-01-01$742.83$467.37RVU18AR1
2017-10-01$586.83$368.87RVU17D
2017-07-01$586.83$368.87RVU17C
2017-04-01$586.83$368.87RVU17B
2017-01-01$586.83$368.87RVU17A
2016-10-01$732.69$463.04RVU16D
2016-07-01$732.69$463.04RVU16C
2016-04-01$732.69$463.04RVU16B
2016-01-01$732.69$463.04RVU16A
2015-10-01$526.28$339.23RVU15D
2015-07-01$526.28$339.23RVU15C
2015-04-01$523.66$337.54RVU15B
2015-01-01$523.66$337.54RVU15A
2014-10-01$699.72$432.32RVU14D
2014-07-01$699.72$432.32RVU14C
2014-04-01$699.72$432.32RVU14B
2014-01-01$699.72$432.32RVU14A
2013-10-01$715.71$432.43RVU13D
2013-07-01$715.71$432.43RVU13C
2013-04-01$715.71$432.43RVU13B
2013-01-01$715.71$432.43RVU13AR

Price 28226 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

28226 billing questions

How is 28226 distinguished from 28225?

28226 describes release of multiple flexor tendons. Use 28225 for the corresponding single-tendon release.

Is this a tendon repair code?

No. This code is for freeing adhesions that restrict tendon glide, not repairing a torn tendon. The operative note should support adhesiolysis rather than repair.

Can a toe flexor tenotomy be reported as 28226?

A tenotomy cuts or divides a tendon, whereas 28226 describes freeing multiple flexor tendons from adhesions. Choose based on the actual procedure documented.

What postoperative care is included?

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

How is bilateral work reported?

For a bilateral procedure, report modifier 50; Medicare pays the code at 150%.

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this code, and 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 28226PPRRVU2026_Oct_nonQPP.csv, line 3,154 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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