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Billing code 26358: Hand tendon repairMedicare rate & RVUs

Reports operative repair or grafting of a hand tendon when the surgeon restores tendon continuity or function through the service represented by this code.

CMS RVU26DEffective Oct 1, 2026109 payment localities74 Medicare services in 2024

Medicare pays $933.22 for 26358 nationally in a facility.

Medicare rate · 26358

Hand tendon repair

Swap in your local Medicare rate.

Work RVUs
12.29
Total RVUs
27.94
Global days
090

National rate · 2026

$933.22

Facility setting, before claim adjustments.

See every locality for 26358 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 26358 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 26358 covers

A hand surgeon reports this service for an operation to repair or reconstruct a tendon in the hand, with a graft included when the procedure requires one. The work may address a tendon disrupted by injury or impaired by a defect that prevents direct repair. The operative report should identify the treated tendon, the hand site, the nature of the tendon problem, and the repair or graft technique. This code describes operative tendon work, not manipulation of a finger or removal of an implant.

Report the code that matches the operation documented; related codes distinguish other hand and finger tendon repair or graft services. The 90-day global period includes 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 adjustment is inappropriate for this code. An assistant at surgery may be paid; 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 26358 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

26358 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$840.94
Alaska*Unavailable$1,127.64
ArizonaUnavailable$907.17
ArkansasUnavailable$829.53
AtlantaUnavailable$958.94
AustinUnavailable$949.37
BakersfieldUnavailable$948.75
Baltimore/Surr. CntysUnavailable$992.24
BeaumontUnavailable$887.83
BrazoriaUnavailable$913.41

26358 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
26358 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 26358 rate is calculated

Each of 26358’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 · 26358

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.29Practice expense 13.04Malpractice 2.61

27.9400 adjusted RVUs×$33.4009 conversion factor=$933.22

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 26358

26358 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26358

Hand tendon repair

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)2Paid.
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 · 26358

Hand tendon repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

26358 without 51 · national facility

$933.22

Hand tendon repair

26358-51 · Second procedure: 50%

$466.61

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

26358 compared with similar codes

Compare codes

26358 vs 26320 vs 26340 vs 26390: national Medicare rates

Swap in your local Medicare rate.

  • 26358
    Hand tendon repair · 12.29 wRVU
    —
  • 26320
    Implant removal · 4 wRVU
    —
  • 26340
    Finger manipulation · 2.73 wRVU
    —
  • 26390
    Tendon revision · 9.19 wRVU
    —

How to choose

26320Implant removal
26320 reports removal of an implant from the hand. Code 26358 concerns hand tendon repair or graft work, not implant removal.
26340Finger manipulation
26340 describes manipulation of a finger under anesthesia. Use 26358 for the documented operative tendon repair or graft service instead.
26390Tendon revision
26390 concerns revision of a hand or finger tendon. Code 26358 represents the repair or graft service described by its operative documentation, not a revision service by default.

Codes related to 26358

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

Codes related to 26358
CodeHow it relatesNational office range
Same family
26350Flexor tendon repairA related hand or finger tendon repair code with a distinct operative descriptor.No office rate
26352Tendon repairAnother repair or graft service in the hand tendon code family.No office rate
26356Flexor tendon repairA related hand or finger tendon repair code; distinguish by its full descriptor.No office rate
26357Flexor tendon repairA neighboring tendon repair code with a distinct procedure definition.No office rate
26372Hand tendon repairAnother hand tendon repair or graft service in this code family.No office rate
26392Hand tendon repairA related hand tendon repair or graft code with a separate descriptor.No office rate

26358 billing questions

What documentation supports reporting this code?

The operative report should identify the hand tendon treated, the underlying tendon problem, and the repair or graft work performed. Document the method and the extent of the procedure.

How is this distinguished from nearby tendon repair codes?

Codes 26350, 26352, 26356, 26357, 26372, and 26392 identify other tendon repair or graft services. Choose the code whose full billing code descriptor matches the documented operation rather than relying on the shared short descriptor.

Can this code be reported with modifier 50?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used to report bilateral payment.

Are related postoperative visits separately included?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.

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 26358PPRRVU2026_Oct_nonQPP.csv, line 2,579 (RVU26D)

Open CMS sourceHow we calculate rates

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