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CPT code 26502: Pulley reconstruction2026 Medicare rate & RVUs

Reconstructs a deficient finger flexor tendon pulley using a free tendon graft, commonly when pulley failure causes tendon bowstringing and impaired finger motion.

CMS RVU26DEffective Oct 1, 2026109 payment localities106 Medicare services in 2024

Medicare pays $745.17 for 26502 nationally in a facility.

Medicare rate · 26502

Pulley reconstruction

Work RVUs
7.13
Total RVUs
22.31
Global days
090

National rate · 2026

$745.17

Facility setting, before claim adjustments.

See every locality for 26502 →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 26502 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 26502 covers

A hand surgeon uses a free tendon graft to rebuild a deficient flexor tendon pulley, restoring the tendon’s close track along the finger. This operation is commonly considered for pulley disruption or deficiency associated with bowstringing and impaired finger flexion, including problems involving the A2 or A4 pulley. It is generally performed in an operating room, with graft harvest and reconstruction documented in the operative report.

Report this code when the surgeon performs pulley reconstruction with a free graft; the graft harvest is included. The record should identify the affected finger and pulley, the structural deficiency and its functional effect, and the graft-based reconstruction performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 26502 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

26502 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$666.31
Alaska*Unavailable$871.45
ArizonaUnavailable$723.79
ArkansasUnavailable$656.45
AtlantaUnavailable$763.27
AustinUnavailable$766.44
BakersfieldUnavailable$773.97
Baltimore/Surr. CntysUnavailable$794.21
BeaumontUnavailable$700.49
BrazoriaUnavailable$731.94

26502 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
26502 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 26502 rate is calculated

Each of 26502’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 · 26502

RVUs × geographic indexes × conversion factor

Work7.13

7.13 RVUs× 1.000 GPCI

Practice expense13.68

13.68 RVUs× 1.000 GPCI

Malpractice1.50

1.50 RVUs× 1.000 GPCI

Adjusted RVUs

22.3100

Conversion factor

$33.4009

Medicare rate

$745.17

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

Payment rules and modifiers for 26502

26502 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26502

Pulley reconstruction

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 · 26502

Pulley reconstruction

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

26502 without 51 · national facility

$745.17

Pulley reconstruction

26502-51 · Second procedure: 50%

$372.59

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

26502 compared with similar codes

Compare codes · National

4 codes, side by side

  • 26502

    Pulley reconstruction7.13 wRVU

    Not priced

  • 26500

    Pulley reconstruction5.98 wRVU

    Not priced

  • 26440

    Flexor tenolysis5.03 wRVU

    Not priced

  • 26510

    Tendon transfer5.46 wRVU

    Not priced

How to choose

26500Pulley reconstruction
Both codes address hand tendon pulley reconstruction; 26502 involves a free tendon graft, while 26500 is used when reconstruction is performed without one.
26440Flexor tenolysis
Use 26440 for release of flexor tendon adhesions. Use 26502 when the pulley itself is reconstructed with a free graft.
26510Tendon transfer
26510 describes a thumb tendon transfer, not reconstruction of a finger flexor pulley with a free graft.

Codes related to 26502

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

Codes related to 26502
CodeHow it relatesNational office range
Same family
26500Pulley reconstructionPulley reconstruction in the same family, performed without a free graft.No office rate
Used instead
26440Flexor tenolysisFor flexor tendon adhesions limiting glide when pulley reconstruction is not the procedure performed.No office rate

26502 billing questions

How is this different from 26500?

This code is for pulley reconstruction using a free tendon graft. Use 26500 for pulley reconstruction without a free graft.

Is harvesting the tendon graft separately reportable?

No. Graft harvest is included in this graft-based reconstruction.

Can modifier 50 be used when both hands are treated?

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

What postoperative care is included?

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

Can an assistant surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.

What documentation supports reporting this code?

Document the affected finger and pulley, the pulley deficiency and resulting functional problem, and the free-graft reconstruction performed.

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 26502PPRRVU2026_Oct_nonQPP.csv, line 2,622 (RVU26D)

Open CMS sourceHow we calculate rates

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