No office rate
Choose 26445 for extensor tendon adhesions in the hand or finger; 26440 concerns flexor tendon release in the palm or finger.
On this page
CMS RVU26D · Effective 2026-10-01
26445 Tendon release Medicare reimbursement rates
Reports surgical release of adhesions restricting an extensor tendon in the hand or finger, typically when limited tendon glide persists after injury or surgery. Compare 26445 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 26445?
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
$530.50–$799.01
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $268.51 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 26445 pays more and less
Hand surgery
About 26445: Extensor tendon adhesion release
Reports surgical release of adhesions restricting an extensor tendon in the hand or finger, typically when limited tendon glide persists after injury or surgery.
Code 26445 represents surgical tenolysis of an extensor tendon in the hand or finger. A hand surgeon may perform it when scar tissue limits tendon glide and active movement, such as after a tendon injury, prior operation, or immobilization. The operative goal is to free the tendon from adhesions while preserving its function; this is different from repairing a torn tendon. The service is commonly performed in an operating room or outpatient surgery setting.
Select this code for the extensor tendon release and site documented in the operative report. Documentation should identify the affected tendon or tendons, the hand or finger location, the adhesions restricting motion, and the release performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred by statutory restriction, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26445
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU4.34 · 24%
- Practice expense (office) RVU12.94 · 71%
- Malpractice RVU0.83 · 5%
2.6K
Medicare services in 2024 · #2270 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.
26445 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Both address extensor tendon adhesions, but 26449 is for the forearm or wrist; 26445 is for the hand or finger.
No office rate
Use 26410 when a hand tendon is repaired. Code 26445 describes freeing an extensor tendon restricted by adhesions, not repairing a tendon injury.
See how rates vary across the country
26445 · 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 26445 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 $538.83 |
| Alaska* | Office Unavailable | Facility $693.02 |
| Arizona | Office Unavailable | Facility $587.50 |
| Arkansas | Office Unavailable | Facility $530.50 |
| Atlanta | Office Unavailable | Facility $617.81 |
| Austin | Office Unavailable | Facility $627.09 |
| Bakersfield | Office Unavailable | Facility $638.30 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $645.33 |
| Beaumont | Office Unavailable | Facility $564.02 |
| Brazoria | Office Unavailable | Facility $596.06 |
| Chicago | Office Unavailable | Facility $643.97 |
| Chico | Office Unavailable | Facility $635.98 |
| Colorado | Office Unavailable | Facility $628.22 |
| Connecticut | Office Unavailable | Facility $646.89 |
| Dallas | Office Unavailable | Facility $600.53 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $692.78 |
| Delaware | Office Unavailable | Facility $597.63 |
| Detroit | Office Unavailable | Facility $608.78 |
| East St. Louis | Office Unavailable | Facility $598.42 |
| El Centro | Office Unavailable | Facility $636.12 |
| Fort Lauderdale | Office Unavailable | Facility $632.91 |
| Fort Worth | Office Unavailable | Facility $596.57 |
| Fresno | Office Unavailable | Facility $635.98 |
| Galveston | Office Unavailable | Facility $598.26 |
| Hanford-Corcoran | Office Unavailable | Facility $635.98 |
| Hawaii, Guam | Office Unavailable | Facility $652.43 |
| Houston | Office Unavailable | Facility $613.45 |
| Idaho | Office Unavailable | Facility $555.70 |
| Indiana | Office Unavailable | Facility $559.09 |
| Iowa | Office Unavailable | Facility $551.44 |
| Kansas | Office Unavailable | Facility $549.65 |
| Kentucky | Office Unavailable | Facility $554.56 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $680.61 |
| Madera | Office Unavailable | Facility $635.98 |
| Manhattan | Office Unavailable | Facility $700.43 |
| Merced | Office Unavailable | Facility $635.98 |
| Metropolitan Boston | Office Unavailable | Facility $691.63 |
| Metropolitan Kansas City | Office Unavailable | Facility $577.89 |
| Metropolitan Philadelphia | Office Unavailable | Facility $630.57 |
| Metropolitan St. Louis | Office Unavailable | Facility $584.20 |
| Miami | Office Unavailable | Facility $665.00 |
| Minnesota | Office Unavailable | Facility $597.91 |
| Mississippi | Office Unavailable | Facility $537.58 |
| Modesto | Office Unavailable | Facility $635.98 |
| Montana** | Office Unavailable | Facility $604.83 |
| Napa | Office Unavailable | Facility $737.83 |
| Nebraska | Office Unavailable | Facility $554.37 |
| Nevada** | Office Unavailable | Facility $600.69 |
| New Hampshire | Office Unavailable | Facility $619.15 |
| New Mexico | Office Unavailable | Facility $574.59 |
| New Orleans | Office Unavailable | Facility $583.16 |
| North Carolina | Office Unavailable | Facility $565.92 |
| North Dakota** | Office Unavailable | Facility $588.42 |
| Northern Nj | Office Unavailable | Facility $685.06 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $719.61 |
| Ohio | Office Unavailable | Facility $567.51 |
| Oklahoma | Office Unavailable | Facility $552.46 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $677.16 |
| Portland | Office Unavailable | Facility $648.09 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $658.29 |
| Puerto Rico | Office Unavailable | Facility $609.23 |
| Queens | Office Unavailable | Facility $705.08 |
| Redding | Office Unavailable | Facility $635.98 |
| Rest Of California | Office Unavailable | Facility $635.98 |
| Rest Of Florida | Office Unavailable | Facility $599.82 |
| Rest Of Georgia | Office Unavailable | Facility $563.53 |
| Rest Of Illinois | Office Unavailable | Facility $582.90 |
| Rest Of Louisiana | Office Unavailable | Facility $554.02 |
| Rest Of Maine | Office Unavailable | Facility $559.83 |
| Rest Of Maryland | Office Unavailable | Facility $609.25 |
| Rest Of Massachusetts | Office Unavailable | Facility $624.49 |
| Rest Of Michigan | Office Unavailable | Facility $570.86 |
| Rest Of Missouri | Office Unavailable | Facility $544.52 |
| Rest Of New Jersey | Office Unavailable | Facility $653.14 |
| Rest Of New York | Office Unavailable | Facility $575.05 |
| Rest Of Oregon | Office Unavailable | Facility $594.93 |
| Rest Of Pennsylvania | Office Unavailable | Facility $567.92 |
| Rest Of Texas | Office Unavailable | Facility $580.16 |
| Rest Of Washington | Office Unavailable | Facility $623.06 |
| Rhode Island | Office Unavailable | Facility $618.91 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $644.92 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $667.70 |
| Salinas | Office Unavailable | Facility $665.24 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $681.25 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $780.87 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $779.93 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $799.01 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $795.15 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $654.57 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $688.00 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $667.83 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $694.92 |
| Seattle (King Cnty) | Office Unavailable | Facility $705.18 |
| South Carolina | Office Unavailable | Facility $567.88 |
| South Dakota** | Office Unavailable | Facility $586.48 |
| Southern Maine | Office Unavailable | Facility $590.77 |
| Stockton | Office Unavailable | Facility $635.98 |
| Suburban Chicago | Office Unavailable | Facility $638.98 |
| Tennessee | Office Unavailable | Facility $552.72 |
| Utah | Office Unavailable | Facility $576.13 |
| Vallejo | Office Unavailable | Facility $736.47 |
| Vermont | Office Unavailable | Facility $586.87 |
| Virgin Islands | Office Unavailable | Facility $609.23 |
| Virginia | Office Unavailable | Facility $589.39 |
| Visalia | Office Unavailable | Facility $635.98 |
| West Virginia | Office Unavailable | Facility $560.22 |
| Wisconsin | Office Unavailable | Facility $567.55 |
| Wyoming** | Office Unavailable | Facility $597.68 |
| Yuba City | Office Unavailable | Facility $635.98 |
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26445 billing questions
How does this differ from code 26440?
Code 26445 is for extensor tendon adhesions in the hand or finger. Code 26440 addresses flexor tendon release in the palm or finger.
When is code 26449 a closer choice?
Use 26449 when the extensor tendon release is in the forearm or wrist. Code 26445 is for the hand or finger.
Is this code for tendon repair?
No. It represents freeing an extensor tendon restricted by adhesions. A repair code is considered when the tendon itself is injured and repaired.
What operative documentation supports reporting it?
Document the extensor tendon and hand or finger site, the adhesions limiting excursion, and the release performed. The operative note should distinguish this work from tendon repair.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.
How do the global and assistant-surgery rules affect billing?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. Assistant-at-surgery payment is barred by statutory restriction; 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.
2,59626437,,Realignment of tendons,A,,5.84,12.49,NA,12.49,,1.12,19.45,19.45,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59726440,,Release palm/finger tendon,A,,5.03,13.25,NA,13.25,,0.96,19.24,19.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59826442,,Release palm & finger tendon,A,,9.51,17.42,NA,17.42,,1.84,28.77,28.77,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59926445,,Release hand/finger tendon,A,,4.34,12.94,NA,12.94,,0.83,18.11,18.11,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60026449,,Release forearm/hand tendon,A,,8.38,9.84,NA,9.84,,1.56,19.78,19.78,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60126450,,Incision of palm tendon,A,,3.70,9.35,NA,9.35,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60226455,,Incision of finger tendon,A,,3.67,9.38,NA,9.38,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00