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Billing code 26432: Tendon repairMedicare rate & RVUs

Reports surgical repair of an extensor tendon where it attaches at a finger’s distal end, including repair for a mallet finger injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities668 Medicare services in 2024

Medicare pays $542.76 for 26432 nationally in a facility.

Medicare rate · 26432

Tendon repair

Swap in your local Medicare rate.

Work RVUs
4.06
Total RVUs
16.25
Global days
090

National rate · 2026

$542.76

Facility setting, before claim adjustments.

See every locality for 26432 → · 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 26432 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 26432 covers

This service repairs an extensor tendon at its distal finger attachment, restoring the tendon’s connection near the distal phalanx. A hand surgeon commonly performs it for a mallet finger injury when surgical repair is indicated. The work may take place in an operating room or an ambulatory surgery setting; the operative report should identify the affected finger, the distal insertion site, and the repair performed.

Select this code when the repair is at the distal insertion and does not use a free graft. Distinguish it from other finger extensor tendon repairs by documenting the repair location and from the grafted counterpart by documenting whether a free graft was used. CMS 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 others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and 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 26432 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

26432 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$483.72
Alaska*Unavailable$623.47
ArizonaUnavailable$527.16
ArkansasUnavailable$476.28
AtlantaUnavailable$554.57
AustinUnavailable$562.11
BakersfieldUnavailable$571.58
Baltimore/Surr. CntysUnavailable$578.98
BeaumontUnavailable$506.62
BrazoriaUnavailable$534.62

26432 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
26432 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 26432 rate is calculated

Each of 26432’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 · 26432

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.06Practice expense 11.40Malpractice 0.79

16.2500 adjusted RVUs×$33.4009 conversion factor=$542.76

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

Payment rules and modifiers for 26432

26432 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26432

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)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 · 26432

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

26432 without 51 · national facility

$542.76

Tendon repair

26432-51 · Second procedure: 50%

$271.38

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

26432 compared with similar codes

Compare codes

26432 vs 26433 vs 26418 vs 26420 vs 26410: national Medicare rates

Swap in your local Medicare rate.

  • 26432
    Tendon repair · 4.06 wRVU
    —
  • 26433
    Tendon repair · 4.58 wRVU
    —
  • 26418
    Finger tendon repair · 4.36 wRVU
    —
  • 26420
    Tendon repair · 6.77 wRVU
    —
  • 26410
    Hand tendon repair · 4.65 wRVU
    —

How to choose

26433Tendon repair
Both address repair at the distal finger extensor tendon insertion. The grafted counterpart applies when the repair uses a free graft.
26418Finger tendon repair
This code is for a finger extensor tendon repair without a free graft away from the distal insertion; 26432 specifies the distal attachment.
26420Tendon repair
This code describes a grafted finger extensor tendon repair at a site other than the distal insertion. For a distal insertion repair, distinguish by graft use and site.
26410Hand tendon repair
This code concerns extensor tendon repair in the hand rather than repair at a finger’s distal tendon insertion.

Codes related to 26432

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

Codes related to 26432
CodeHow it relatesNational office range
Same family
26433Tendon repairDistal finger extensor insertion repair when a free graft is used.No office rate
26418Finger tendon repairFinger extensor tendon repair without a free graft at a site other than the distal insertion.No office rate
26420Tendon repairFinger extensor tendon repair with a free graft at a site other than the distal insertion.No office rate

26432 billing questions

When is this code a better fit than a general finger extensor tendon repair code?

Use it when the operative report identifies repair at the tendon’s distal insertion on the finger, as in a surgically treated mallet finger. A repair at another finger tendon site may call for a different code.

How does the grafted counterpart differ?

The key distinction is whether the distal insertion repair uses a free tendon graft. Report this code for repair without a free graft; use the grafted counterpart when a free graft is used.

What documentation supports reporting this service?

Document the injured finger, the distal tendon attachment being repaired, the operative repair, and whether a free graft was used. The diagnosis and operative findings should support why surgical repair was performed.

Can modifier 50 be used when both hands or fingers are involved?

CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. Identify the treated finger or fingers in the claim documentation.

What postoperative care is included in the global period?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. CMS also applies the standard multiple procedure reduction when other procedures are performed in the same session.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay an assistant at surgery 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 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 26432PPRRVU2026_Oct_nonQPP.csv, line 2,593 (RVU26D)

Open CMS sourceHow we calculate rates

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