FeeBase
Log inGet started
Menu

Billing code 26497: Tendon transferMedicare rate & RVUs

Reports transfer of a flexor tendon in a finger to restore useful movement when the original tendon function is impaired.

CMS RVU26DEffective Oct 1, 2026109 payment localities96 Medicare services in 2024

Medicare pays $879.78 for 26497 nationally in a facility.

Medicare rate · 26497

Tendon transfer

Work RVUs
9.52
Total RVUs
26.34
Global days
090

National rate · 2026

$879.78

Facility setting, before claim adjustments.

See every locality for 26497 →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 26497 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 26497 covers

A hand surgeon transfers a flexor tendon to restore or improve finger movement when the existing tendon cannot provide adequate function. The operation redirects tendon force to a recipient attachment; the specific donor tendon, recipient finger, and functional problem depend on the reconstruction. It is typically performed in an operating room by an orthopedic or plastic surgeon specializing in hand surgery.

Report this code for the finger flexor tendon transfer itself, not for tendon release or lengthening alone. The operative report should identify the transferred tendon, recipient site, finger, and reason for redirecting its pull. The 90-day global period includes the day-before preoperative visit and 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; 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 26497 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

26497 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$788.50
Alaska*Unavailable$1,040.26
ArizonaUnavailable$854.66
ArkansasUnavailable$777.13
AtlantaUnavailable$902.33
AustinUnavailable$901.28
BakersfieldUnavailable$906.57
Baltimore/Surr. CntysUnavailable$937.05
BeaumontUnavailable$830.51
BrazoriaUnavailable$862.89

26497 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
26497 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 26497 rate is calculated

Each of 26497’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 · 26497

RVUs × geographic indexes × conversion factor

Work9.52

9.52 RVUs× 1.000 GPCI

Practice expense14.78

14.78 RVUs× 1.000 GPCI

Malpractice2.04

2.04 RVUs× 1.000 GPCI

Adjusted RVUs

26.3400

Conversion factor

$33.4009

Medicare rate

$879.78

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

Payment rules and modifiers for 26497

26497 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26497

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)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 · 26497

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

26497 without 51 · national facility

$879.78

Tendon transfer

26497-51 · Second procedure: 50%

$439.89

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

26497 compared with similar codes

Compare codes · National

5 codes, side by side

  • 26497

    Tendon transfer9.52 wRVU

    Not priced

  • 26498

    Tendon transfer13.85 wRVU

    Not priced

  • 26494

    Tendon transfer8.44 wRVU

    Not priced

  • 26492

    Tendon transfer9.59 wRVU

    Not priced

  • 26440

    Flexor tenolysis5.03 wRVU

    Not priced

How to choose

26498Tendon transfer
Use 26497 for transfer of a finger flexor tendon; 26498 describes the corresponding transfer involving a finger extensor tendon.
26494Tendon transfer
26494 covers a hand tendon or muscle transfer. Choose 26497 when the transferred structure and operative work are specifically a finger flexor tendon transfer.
26492Tendon transfer
26492 concerns a thumb tendon transfer with a graft. It is not the code for a finger flexor tendon transfer.
26440Flexor tenolysis
26440 is a flexor tendon release for adhesions in the palm or finger. It does not describe transferring the tendon to redirect its pull.

Codes related to 26497

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

Codes related to 26497
CodeHow it relatesNational office range
Same family
26498Tendon transferFinger extensor tendon transfer; distinguished from this code's flexor tendon work.No office rate
Used instead
26494Tendon transferHand tendon or muscle transfer when the procedure is not the finger flexor transfer described here.No office rate
26492Tendon transferThumb tendon transfer with a graft, rather than a finger flexor tendon transfer.No office rate
26480Tendon transferTendon transfer or transplant in the carpometacarpal region or dorsum of the hand.No office rate
26440Flexor tenolysisFlexor tendon release for adhesions, not tendon redirection to a new attachment.No office rate

26497 billing questions

How does 26497 differ from 26498?

26497 is for transfer of a finger flexor tendon. 26498 is the corresponding finger extensor tendon transfer.

Can 26497 be reported for tendon release or lengthening?

No. The procedure must redirect a flexor tendon to a new attachment; release and lengthening describe different work.

What should the operative report document?

Identify the donor tendon, recipient attachment, finger treated, and functional problem prompting the transfer. The documentation should make clear that a transfer was performed rather than an isolated release or lengthening.

Should modifier 50 be used for bilateral finger transfers?

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

How does the global period affect postoperative visits?

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

Can an assistant surgeon be paid for this procedure?

Assistant-at-surgery payment may be made. 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 26497PPRRVU2026_Oct_nonQPP.csv, line 2,618 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26497 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 26497 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 →