No office rate
26040 describes percutaneous division of a palmar cord; 26045 is used when the release is performed through an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
26040 Palm contracture release Medicare reimbursement rates
Percutaneous palmar cord release divides contracted fascia in a hand with Dupuytren’s contracture to improve finger extension without an open approach. Compare 26040 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26040?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$273.86–$388.90
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $115.04 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 26040 pays more and less
Hand surgery
About 26040: Percutaneous palmar cord release
Percutaneous palmar cord release divides contracted fascia in a hand with Dupuytren’s contracture to improve finger extension without an open approach.
The physician releases a contracted palmar fascial cord by dividing it through the skin, typically with a needle or similar percutaneous instrument. Hand surgeons commonly perform this treatment for Dupuytren’s contracture when a cord limits finger extension, in an office or outpatient surgical setting. The technique releases the cord rather than removing a segment of palmar fascia through an open incision.
Choose this code when the documented method is percutaneous; an open release or fasciectomy is a different service. The record should identify the treated hand and cord, the contracture and its effect on motion, and the technique used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, payment is 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 26040
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.37 · 36%
- Practice expense (office) RVU5.25 · 57%
- Malpractice RVU0.62 · 7%
5K
Medicare services in 2024 · #1865 by national volume
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.
26040 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
26040 releases a cord percutaneously. 26121 describes an open partial palmar fasciectomy, which removes palmar fascia.
$548.44–$856.74
26055 treats a stenosing flexor tendon sheath, such as trigger finger. 26040 addresses a contracted palmar fascial cord.
See how rates vary across the country
26040 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 26040 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $277.72 |
| Alaska* | Office Unavailable | Facility $367.00 |
| Arizona | Office Unavailable | Facility $300.21 |
| Arkansas | Office Unavailable | Facility $273.86 |
| Atlanta | Office Unavailable | Facility $315.93 |
| Austin | Office Unavailable | Facility $316.66 |
| Bakersfield | Office Unavailable | Facility $319.50 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $328.13 |
| Beaumont | Office Unavailable | Facility $291.37 |
| Brazoria | Office Unavailable | Facility $303.39 |
| Chicago | Office Unavailable | Facility $337.11 |
| Chico | Office Unavailable | Facility $317.76 |
| Colorado | Office Unavailable | Facility $316.66 |
| Connecticut | Office Unavailable | Facility $328.73 |
| Dallas | Office Unavailable | Facility $306.00 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $348.26 |
| Delaware | Office Unavailable | Facility $304.99 |
| Detroit | Office Unavailable | Facility $316.69 |
| East St. Louis | Office Unavailable | Facility $315.59 |
| El Centro | Office Unavailable | Facility $317.87 |
| Fort Lauderdale | Office Unavailable | Facility $327.64 |
| Fort Worth | Office Unavailable | Facility $304.51 |
| Fresno | Office Unavailable | Facility $317.76 |
| Galveston | Office Unavailable | Facility $304.74 |
| Hanford-Corcoran | Office Unavailable | Facility $317.76 |
| Hawaii, Guam | Office Unavailable | Facility $323.93 |
| Houston | Office Unavailable | Facility $316.08 |
| Idaho | Office Unavailable | Facility $283.68 |
| Indiana | Office Unavailable | Facility $285.18 |
| Iowa | Office Unavailable | Facility $281.23 |
| Kansas | Office Unavailable | Facility $281.52 |
| Kentucky | Office Unavailable | Facility $287.40 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $338.37 |
| Madera | Office Unavailable | Facility $317.76 |
| Manhattan | Office Unavailable | Facility $356.37 |
| Merced | Office Unavailable | Facility $317.76 |
| Metropolitan Boston | Office Unavailable | Facility $344.98 |
| Metropolitan Kansas City | Office Unavailable | Facility $297.45 |
| Metropolitan Philadelphia | Office Unavailable | Facility $321.84 |
| Metropolitan St. Louis | Office Unavailable | Facility $300.25 |
| Miami | Office Unavailable | Facility $347.48 |
| Minnesota | Office Unavailable | Facility $299.13 |
| Mississippi | Office Unavailable | Facility $278.85 |
| Modesto | Office Unavailable | Facility $317.76 |
| Montana** | Office Unavailable | Facility $308.58 |
| Napa | Office Unavailable | Facility $361.29 |
| Nebraska | Office Unavailable | Facility $282.24 |
| Nevada** | Office Unavailable | Facility $305.34 |
| New Hampshire | Office Unavailable | Facility $313.23 |
| New Mexico | Office Unavailable | Facility $298.23 |
| New Orleans | Office Unavailable | Facility $301.09 |
| North Carolina | Office Unavailable | Facility $289.40 |
| North Dakota** | Office Unavailable | Facility $296.32 |
| Northern Nj | Office Unavailable | Facility $345.18 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $366.72 |
| Ohio | Office Unavailable | Facility $293.53 |
| Oklahoma | Office Unavailable | Facility $285.24 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $335.88 |
| Portland | Office Unavailable | Facility $324.59 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $334.70 |
| Puerto Rico | Office Unavailable | Facility $310.24 |
| Queens | Office Unavailable | Facility $356.90 |
| Redding | Office Unavailable | Facility $317.76 |
| Rest Of California | Office Unavailable | Facility $317.76 |
| Rest Of Florida | Office Unavailable | Facility $311.33 |
| Rest Of Georgia | Office Unavailable | Facility $293.66 |
| Rest Of Illinois | Office Unavailable | Facility $305.03 |
| Rest Of Louisiana | Office Unavailable | Facility $287.59 |
| Rest Of Maine | Office Unavailable | Facility $286.77 |
| Rest Of Maryland | Office Unavailable | Facility $310.16 |
| Rest Of Massachusetts | Office Unavailable | Facility $315.52 |
| Rest Of Michigan | Office Unavailable | Facility $296.04 |
| Rest Of Missouri | Office Unavailable | Facility $283.89 |
| Rest Of New Jersey | Office Unavailable | Facility $331.27 |
| Rest Of New York | Office Unavailable | Facility $293.71 |
| Rest Of Oregon | Office Unavailable | Facility $301.77 |
| Rest Of Pennsylvania | Office Unavailable | Facility $293.11 |
| Rest Of Texas | Office Unavailable | Facility $297.67 |
| Rest Of Washington | Office Unavailable | Facility $314.43 |
| Rhode Island | Office Unavailable | Facility $314.31 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $324.44 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $331.65 |
| Salinas | Office Unavailable | Facility $330.39 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $336.89 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $380.01 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $379.31 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $388.90 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $386.03 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $325.30 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $339.08 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $331.28 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $342.37 |
| Seattle (King Cnty) | Office Unavailable | Facility $350.27 |
| South Carolina | Office Unavailable | Facility $292.19 |
| South Dakota** | Office Unavailable | Facility $294.87 |
| Southern Maine | Office Unavailable | Facility $299.40 |
| Stockton | Office Unavailable | Facility $317.76 |
| Suburban Chicago | Office Unavailable | Facility $330.13 |
| Tennessee | Office Unavailable | Facility $283.08 |
| Utah | Office Unavailable | Facility $295.99 |
| Vallejo | Office Unavailable | Facility $360.28 |
| Vermont | Office Unavailable | Facility $296.64 |
| Virgin Islands | Office Unavailable | Facility $310.24 |
| Virginia | Office Unavailable | Facility $299.55 |
| Visalia | Office Unavailable | Facility $317.76 |
| West Virginia | Office Unavailable | Facility $294.58 |
| Wisconsin | Office Unavailable | Facility $286.93 |
| Wyoming** | Office Unavailable | Facility $303.24 |
| Yuba City | Office Unavailable | Facility $317.76 |
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26040 billing questions
How does 26040 differ from 26045?
26040 is for a percutaneous cord release. Use 26045 when the palmar release is performed through an open approach.
When is a percutaneous release appropriate to report?
Report it when the physician divides a contracted palmar fascial cord through the skin, such as for Dupuytren’s contracture limiting finger extension. The documentation should support the percutaneous method.
Can an open fasciectomy be reported as 26040?
No. Removal of palmar fascia through an open approach is a different service; distinguish it from percutaneous division of a cord.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure paid?
CMS pays bilateral procedures reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,53226034,,Treat hand bone lesion,A,,6.46,8.03,NA,8.03,,1.26,15.75,15.75,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53326035,,Decompress fingers/hand,A,,11.09,10.96,NA,10.96,,2.36,24.41,24.41,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53426037,,Decompress fingers/hand,A,,7.38,6.96,NA,6.96,,1.44,15.78,15.78,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53526040,,Release palm contracture,A,,3.37,5.25,NA,5.25,,0.62,9.24,9.24,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53626045,,Release palm contracture,A,,5.59,6.87,NA,6.87,,1.11,13.57,13.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53726055,,Incise finger tendon sheath,A,,3.03,15.24,,5.00,,0.58,18.85,8.61,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,53826060,,Incision of finger tendon,A,,2.84,4.00,NA,4.00,,0.45,7.29,7.29,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00