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Billing code 26474: Tendon tenodesisMedicare rate & RVUs

Reports surgical fixation of a finger extensor tendon to stabilize or control finger position when tendon balance or function requires correction.

CMS RVU26DEffective Oct 1, 2026109 payment localities38 Medicare services in 2024

Medicare pays $654.99 for 26474 nationally in a facility.

Medicare rate · 26474

Tendon tenodesis

Swap in your local Medicare rate.

Work RVUs
5.35
Total RVUs
19.61
Global days
090

National rate · 2026

$654.99

Facility setting, before claim adjustments.

See every locality for 26474 → · 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 26474 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 26474 covers

This procedure fixes a finger extensor tendon to a stable structure, such as bone, to limit or guide finger movement. Hand surgeons typically perform it for selected finger deformities or functional problems in which stabilizing the extensor mechanism is the operative goal. The specific technique and structures addressed depend on the patient’s anatomy and the surgical plan.

Report 26474 when the operative work is extensor tendon tenodesis of a finger; flexor tendon tenodesis is a different service. The operative report should identify the finger, tendon, fixation performed, and reason for stabilization. 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon and team-surgery billing 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 26474 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

26474 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$583.69
Alaska*Unavailable$755.73
ArizonaUnavailable$635.92
ArkansasUnavailable$574.74
AtlantaUnavailable$670.19
AustinUnavailable$676.43
BakersfieldUnavailable$685.57
Baltimore/Surr. CntysUnavailable$698.87
BeaumontUnavailable$612.85
BrazoriaUnavailable$644.10

26474 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
26474 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 26474 rate is calculated

Each of 26474’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 · 26474

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.35Practice expense 13.12Malpractice 1.14

19.6100 adjusted RVUs×$33.4009 conversion factor=$654.99

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

Payment rules and modifiers for 26474

26474 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26474

Tendon tenodesis

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 · 26474

Tendon tenodesis

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

26474 without 51 · national facility

$654.99

Tendon tenodesis

26474-51 · Second procedure: 50%

$327.50

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

26474 compared with similar codes

Compare codes

26474 vs 26471 vs 26437 vs 26476 vs 26497: national Medicare rates

Swap in your local Medicare rate.

  • 26474
    Tendon tenodesis · 5.35 wRVU
    —
  • 26471
    Finger tenodesis · 5.75 wRVU
    —
  • 26437
    Tendon realignment · 5.84 wRVU
    —
  • 26476
    Tendon lengthening · 5.22 wRVU
    —
  • 26497
    Tendon transfer · 9.52 wRVU
    —

How to choose

26471Finger tenodesis
Use 26474 for extensor tendon tenodesis in a finger and 26471 for flexor tendon tenodesis.
26437Tendon realignment
26437 describes tendon realignment; 26474 is selected when the operative work fixes the extensor tendon for stabilization.
26476Tendon lengthening
26476 is for tendon lengthening. Choose 26474 when fixation of the extensor tendon, rather than a change in tendon length, is performed.
26497Tendon transfer
26497 describes a finger tendon transfer. Tenodesis under 26474 stabilizes the extensor tendon instead of rerouting it to provide a different function.

Codes related to 26474

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

Codes related to 26474
CodeHow it relatesNational office range
Same family
26471Finger tenodesisFinger flexor tendon tenodesis; this code covers the extensor tendon.No office rate
Used instead
26437Tendon realignmentTendon realignment is a different approach when the operation repositions rather than fixes the tendon.No office rate
26476Tendon lengtheningFinger tendon lengthening changes tendon length rather than stabilizing it by tenodesis.No office rate
26477Tendon shorteningFinger tendon shortening changes tendon length rather than fixing it for stabilization.No office rate
26497Tendon transferFinger tendon transfer reroutes a tendon to change function rather than perform tenodesis.No office rate

26474 billing questions

How does 26474 differ from 26471?

26474 is for finger extensor tendon tenodesis; 26471 is for finger flexor tendon tenodesis. Use the tendon treated in the operative procedure to distinguish them.

What documentation supports 26474?

Document the finger and extensor tendon treated, the fixation performed, and the clinical reason for stabilizing the tendon. The operative note should make clear that the work was tenodesis rather than tendon realignment or length alteration.

Can modifier 50 be used for bilateral work?

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

What postoperative care is included?

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

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted 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 26474PPRRVU2026_Oct_nonQPP.csv, line 2,605 (RVU26D)

Open CMS sourceHow we calculate rates

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