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Billing code 26496: Thumb tendon transferMedicare rate & RVUs

Reports operative transfer or transplantation of multiple thumb tendons using a free graft to restore thumb motion or function.

CMS RVU26DEffective Oct 1, 2026109 payment localities90 Medicare services in 2024

Medicare pays $880.78 for 26496 nationally in a facility.

Medicare rate · 26496

Thumb tendon transfer

Work RVUs
9.54
Total RVUs
26.37
Global days
090

National rate · 2026

$880.78

Facility setting, before claim adjustments.

See every locality for 26496 →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 26496 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 26496 covers

This code represents operative transfer or transplantation involving multiple thumb tendons with a free graft. The surgeon redirects tendon function and uses a graft to bridge or augment the reconstruction. It may be performed by a hand or orthopedic surgeon for traumatic tendon loss or chronic dysfunction that impairs thumb movement. The operative report should establish the thumb tendons involved and describe the graft and reconstruction performed.

Select this code when the documented procedure involves multiple thumb tendons and a free graft; a single tendon or a reconstruction without a free graft points to a different code in the family. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other 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 payment requires documentation of medical necessity; 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 26496 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

26496 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$789.46
Alaska*Unavailable$1,041.62
ArizonaUnavailable$855.66
ArkansasUnavailable$778.08
AtlantaUnavailable$903.34
AustinUnavailable$902.30
BakersfieldUnavailable$907.62
Baltimore/Surr. CntysUnavailable$938.09
BeaumontUnavailable$831.48
BrazoriaUnavailable$863.89

26496 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
26496 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 26496 rate is calculated

Each of 26496’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 · 26496

RVUs × geographic indexes × conversion factor

Work9.54

9.54 RVUs× 1.000 GPCI

Practice expense14.79

14.79 RVUs× 1.000 GPCI

Malpractice2.04

2.04 RVUs× 1.000 GPCI

Adjusted RVUs

26.3700

Conversion factor

$33.4009

Medicare rate

$880.78

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26496

26496 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26496

Thumb tendon transfer

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)0Not paid without supporting documentation.
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 · 26496

Thumb tendon transfer

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.

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

26496 without 51 · national facility

$880.78

Thumb tendon transfer

26496-51 · Second procedure: 50%

$440.39

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

26496 compared with similar codes

Compare codes · National

5 codes, side by side

  • 26496

    Thumb tendon transfer9.54 wRVU

    Not priced

  • 26494

    Tendon transfer8.44 wRVU

    Not priced

  • 26492

    Tendon transfer9.59 wRVU

    Not priced

  • 26480

    Tendon transfer8.78 wRVU

    Not priced

  • 26497

    Tendon transfer9.52 wRVU

    Not priced

How to choose

26494Tendon transfer
Use 26494 for the multiple-tendon thumb reconstruction when no free graft is used. The free graft is the key distinction for 26496.
26492Tendon transfer
This is the single-tendon thumb reconstruction with a free graft; 26496 is for multiple thumb tendons with a free graft.
26480Tendon transfer
This code addresses tendon transfer or transplantation in the carpometacarpal area or dorsum of the hand. Choose 26496 for the multiple-tendon thumb procedure with a free graft.
26497Tendon transfer
This code concerns finger tendon transfer. Code 26496 is the thumb-specific multiple-tendon reconstruction with a free graft.

Codes related to 26496

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

Codes related to 26496
CodeHow it relatesNational office range
Same family
26490Thumb tendon repairThumb tendon transfer or transplantation involving a single tendon without a free graft.No office rate
26492Tendon transferThumb tendon transfer or transplantation involving a single tendon with a free graft.No office rate
26494Tendon transferThumb tendon transfer or transplantation involving multiple tendons without a free graft.No office rate
Used instead
26480Tendon transferTendon transfer or transplantation at the hand's carpometacarpal area or dorsum, rather than the thumb-specific service.No office rate
26483Tendon transferHand tendon transfer or transplantation with a free graft at a different anatomic scope.No office rate

26496 billing questions

How does this code differ from 26494?

Both concern multiple thumb tendons, but 26496 is selected when the reconstruction uses a free graft. Code 26494 describes the multiple-tendon alternative without a free graft.

What documentation supports reporting this code?

The operative report should identify the thumb tendons treated, describe the transfer or transplant, and document use of a free graft. It should make clear that multiple tendons were involved.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

How does the 90-day global period affect postoperative reporting?

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

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

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

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 26496PPRRVU2026_Oct_nonQPP.csv, line 2,617 (RVU26D)

Open CMS sourceHow we calculate rates

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