FeeBase
Log inGet started
Menu

Billing code 26477: Tendon shorteningMedicare rate & RVUs

Reports surgical shortening of a hand or finger tendon, counted for each tendon treated to correct excessive length or tendon imbalance.

CMS RVU26DEffective Oct 1, 2026109 payment localities122 Medicare services in 2024

Medicare pays $613.91 for 26477 nationally in a facility.

Medicare rate · 26477

Tendon shortening

Swap in your local Medicare rate.

Work RVUs
5.19
Total RVUs
18.38
Global days
090

National rate · 2026

$613.91

Facility setting, before claim adjustments.

See every locality for 26477 → · 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 26477 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 26477 covers

billing code 26477 describes an operation that reduces the effective length of a hand or finger tendon and secures it at the corrected length. A hand, orthopedic, or plastic surgeon may perform it in an operating room when tendon length or tension needs correction to improve position or function. The operative report should identify the tendon and site and describe the shortening performed and the clinical problem being treated.

Report the service for each tendon shortened, with documentation supporting the number of tendons treated. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Do not use modifier 50 for bilateral adjustment. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is 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 26477 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

26477 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$548.62
Alaska*Unavailable$712.22
ArizonaUnavailable$596.51
ArkansasUnavailable$540.41
AtlantaUnavailable$627.59
AustinUnavailable$634.12
BakersfieldUnavailable$643.39
Baltimore/Surr. CntysUnavailable$654.27
BeaumontUnavailable$574.89
BrazoriaUnavailable$604.35

26477 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
26477 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 26477 rate is calculated

Each of 26477’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 · 26477

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.19Practice expense 12.20Malpractice 0.99

18.3800 adjusted RVUs×$33.4009 conversion factor=$613.91

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

Payment rules and modifiers for 26477

26477 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26477

Tendon shortening

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)1Permitted with supporting documentation.
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 · 26477

Tendon shortening

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

26477 without 51 · national facility

$613.91

Tendon shortening

26477-51 · Second procedure: 50%

$306.96

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

26477 compared with similar codes

Compare codes

26477 vs 26476 vs 26478 vs 26479 vs 26437: national Medicare rates

Swap in your local Medicare rate.

  • 26477
    Tendon shortening · 5.19 wRVU
    —
  • 26476
    Tendon lengthening · 5.22 wRVU
    —
  • 26478
    Tendon lengthening · 5.82 wRVU
    —
  • 26479
    Tendon shortening · 5.76 wRVU
    —
  • 26437
    Tendon realignment · 5.84 wRVU
    —

How to choose

26476Tendon lengthening
26477 is for shortening a tendon; 26476 is for lengthening one. The operative report should establish which change in tendon length was performed.
26478Tendon lengthening
26478 describes hand-tendon lengthening. Choose 26477 when the tendon is shortened instead.
26479Tendon shortening
Both codes concern tendon shortening in the hand region. Check the full code descriptors and operative details to determine which anatomical and service distinction applies.
26437Tendon realignment
26437 addresses tendon realignment. Use 26477 when the documented operation shortens the tendon rather than realigning it.

Codes related to 26477

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

Codes related to 26477
CodeHow it relatesNational office range
Used instead
26476Tendon lengtheningUsed for tendon lengthening rather than shortening.No office rate
26478Tendon lengtheningA hand-tendon lengthening service, not a shortening procedure.No office rate
26437Tendon realignmentRealigns tendons rather than shortening a tendon.No office rate
26480Tendon transferTransplants a hand tendon instead of shortening it.No office rate
Same family
26479Tendon shorteningA related hand-tendon shortening code; distinguish it by the applicable tendon and code descriptor.No office rate

26477 billing questions

How is 26477 different from tendon lengthening?

Use 26477 when the operation shortens the tendon. Tendon lengthening is a different service; select the code that matches the direction of the tendon-length change documented in the operative report.

How many units should be reported?

The code is reported for each tendon shortened. The operative report should identify each tendon treated.

Does 26477 include related postoperative visits?

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

Can modifier 50 be used when both hands are treated?

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

How are other procedures in the same session paid?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery is not paid for this service. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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 26477PPRRVU2026_Oct_nonQPP.csv, line 2,607 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26477 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 26477 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →