Billing code 28226: Tendon releaseMedicare rate & RVUs
Open tenolysis of multiple foot or toe flexor tendons frees restricted tendon glide when adhesions limit motion after injury or prior surgery.
Medicare pays $665.35 for 28226 nationally in the office and $390.79 in a hospital or facility. Local office rates run $581.70–$879.32.
Medicare rate · 28226
Tendon release
Swap in your local Medicare rate.
- Work RVUs
- 4.55
- Total RVUs
- 19.92
- Global days
- 090
National rate · 2026
$665.35
Office setting, before claim adjustments.
See every locality for 28226 → · 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
What 28226 covers
This procedure surgically frees adhesions restricting the glide of multiple flexor tendons in the foot or toes. An orthopedic or podiatric surgeon typically performs it in an operating room when scar tissue limits tendon excursion, often after prior trauma or surgery. The operative work is directed at freeing the tendons, rather than repairing a tendon rupture or cutting a tendon to correct deformity.
Report the code when the surgeon documents open adhesiolysis involving multiple flexor tendons; the operative note should identify the tendons treated and the adhesion release performed. A release of a single flexor tendon is distinguished by the neighboring single-tendon code. 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. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 28226 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$581.70 to $879.32
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $591.06 | $350.82 |
| Alaska* | $757.88 | $465.48 |
| Arizona | $645.73 | $379.69 |
| Arkansas | $581.70 | $345.86 |
| Atlanta | $680.07 | $401.12 |
| Austin | $689.80 | $399.32 |
| Bakersfield | $701.58 | $400.66 |
| Baltimore/Surr. Cntys | $710.62 | $416.02 |
| Beaumont | $619.76 | $369.92 |
| Brazoria | $655.03 | $382.95 |
| Chicago | $711.20 | $435.27 |
| Chico | $698.88 | $397.97 |
| Colorado | $690.76 | $398.64 |
| Connecticut | $712.27 | $416.57 |
| Dallas | $660.14 | $386.69 |
| Dc + Md/Va Suburbs | $762.81 | $439.38 |
| Delaware | $657.03 | $385.77 |
| Detroit | $670.98 | $406.03 |
| East St. Louis | $660.09 | $407.49 |
| El Centro | $699.05 | $398.13 |
| Fort Lauderdale | $698.04 | $419.92 |
| Fort Worth | $655.76 | $385.05 |
| Fresno | $698.88 | $397.97 |
| Galveston | $657.57 | $384.93 |
| Hanford-Corcoran | $698.88 | $397.97 |
| Hawaii, Guam | $717.41 | $405.24 |
| Houston | $675.50 | $402.87 |
| Idaho | $609.64 | $357.05 |
| Indiana | $613.43 | $358.92 |
| Iowa | $604.75 | $353.54 |
| Kansas | $602.97 | $354.77 |
| Kentucky | $609.21 | $365.13 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $748.54 | $423.74 |
| Madera | $698.88 | $397.97 |
| Manhattan | $772.12 | $453.08 |
| Merced | $698.88 | $397.97 |
| Metropolitan Boston | $761.22 | $433.40 |
| Metropolitan Kansas City | $635.27 | $377.47 |
| Metropolitan Philadelphia | $694.11 | $408.29 |
| Metropolitan St. Louis | $642.34 | $380.96 |
| Miami | $735.10 | $449.29 |
| Minnesota | $656.24 | $373.72 |
| Mississippi | $589.99 | $353.60 |
| Modesto | $698.88 | $397.97 |
| Montana** | $665.28 | $390.73 |
| Napa | $811.66 | $449.79 |
| Nebraska | $607.98 | $354.56 |
| Nevada** | $660.36 | $385.53 |
| New Hampshire | $680.96 | $395.15 |
| New Mexico | $632.03 | $380.26 |
| New Orleans | $641.44 | $383.08 |
| North Carolina | $621.33 | $365.17 |
| North Dakota** | $645.90 | $371.35 |
| Northern Nj | $754.05 | $435.56 |
| Nyc Suburbs/Long Island | $793.97 | $467.52 |
| Ohio | $623.79 | $373.12 |
| Oklahoma | $606.62 | $361.44 |
| Oxnard-Thousand Oaks-Ventura | $744.74 | $420.21 |
| Portland | $712.75 | $407.72 |
| Poughkpsie/N Nyc Suburbs | $724.72 | $424.08 |
| Puerto Rico | $670.14 | $392.57 |
| Queens | $777.02 | $452.49 |
| Redding | $698.88 | $397.97 |
| Rest Of California | $698.88 | $397.97 |
| Rest Of Florida | $660.66 | $398.19 |
| Rest Of Georgia | $619.72 | $374.82 |
| Rest Of Illinois | $641.96 | $391.29 |
| Rest Of Louisiana | $608.70 | $365.72 |
| Rest Of Maine | $614.52 | $361.93 |
| Rest Of Maryland | $669.95 | $392.10 |
| Rest Of Massachusetts | $686.61 | $397.50 |
| Rest Of Michigan | $627.75 | $377.08 |
| Rest Of Missouri | $598.17 | $361.50 |
| Rest Of New Jersey | $718.82 | $419.00 |
| Rest Of New York | $631.59 | $370.76 |
| Rest Of Oregon | $653.70 | $380.24 |
| Rest Of Pennsylvania | $624.13 | $372.09 |
| Rest Of Texas | $637.66 | $377.11 |
| Rest Of Washington | $684.97 | $395.87 |
| Rhode Island | $680.56 | $396.94 |
| Riverside-San Bernardino-Ontario | $709.41 | $408.50 |
| Sacramento-Roseville-Folsom | $733.97 | $414.67 |
| Salinas | $731.29 | $413.08 |
| San Diego-Chula Vista-Carlsbad | $749.12 | $420.75 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $859.14 | $472.01 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $858.02 | $470.90 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $879.32 | $483.41 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $874.77 | $478.86 |
| San Luis Obispo-Paso Robles | $719.55 | $406.83 |
| Santa Cruz-Watsonville | $756.69 | $423.10 |
| Santa Maria-Santa Barbara | $734.20 | $414.07 |
| Santa Rosa-Petaluma | $764.30 | $427.15 |
| Seattle (King Cnty) | $776.06 | $439.18 |
| South Carolina | $623.91 | $370.22 |
| South Dakota** | $643.61 | $369.06 |
| Southern Maine | $648.94 | $376.86 |
| Stockton | $698.88 | $397.97 |
| Suburban Chicago | $704.66 | $422.69 |
| Tennessee | $606.45 | $356.88 |
| Utah | $633.17 | $375.09 |
| Vallejo | $810.05 | $448.19 |
| Vermont | $644.37 | $372.56 |
| Virgin Islands | $670.14 | $392.57 |
| Virginia | $647.55 | $377.66 |
| Visalia | $698.88 | $397.97 |
| West Virginia | $616.49 | $377.90 |
| Wisconsin | $622.51 | $359.48 |
| Wyoming** | $656.84 | $382.28 |
| Yuba City | $698.88 | $397.97 |
28226 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$581.70
$789.10
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $757.88 | 1 |
| AL | $591.06 | 1 |
| AR | $581.70 | 1 |
| AZ | $645.73 | 1 |
| CA | $698.88–$879.32 | 29 |
| CO | $690.76 | 1 |
| CT | $712.27 | 1 |
| DC | $762.81 | 1 |
| DE | $657.03 | 1 |
| FL | $660.66–$735.10 | 3 |
| GA | $619.72–$680.07 | 2 |
| GU | $717.41 | 1 |
| HI | $717.41 | 1 |
| IA | $604.75 | 1 |
| ID | $609.64 | 1 |
| IL | $641.96–$711.20 | 4 |
| IN | $613.43 | 1 |
| KS | $602.97 | 1 |
| KY | $609.21 | 1 |
| LA | $608.70–$641.44 | 2 |
| MA | $686.61–$761.22 | 2 |
| MD | $669.95–$762.81 | 3 |
| ME | $614.52–$648.94 | 2 |
| MI | $627.75–$670.98 | 2 |
| MN | $656.24 | 1 |
| MO | $598.17–$642.34 | 3 |
| MS | $589.99 | 1 |
| MT | $665.28 | 1 |
| NC | $621.33 | 1 |
| ND | $645.90 | 1 |
| NE | $607.98 | 1 |
| NH | $680.96 | 1 |
| NJ | $718.82–$754.05 | 2 |
| NM | $632.03 | 1 |
| NV | $660.36 | 1 |
| NY | $631.59–$793.97 | 5 |
| OH | $623.79 | 1 |
| OK | $606.62 | 1 |
| OR | $653.70–$712.75 | 2 |
| PA | $624.13–$694.11 | 2 |
| PR | $670.14 | 1 |
| RI | $680.56 | 1 |
| SC | $623.91 | 1 |
| SD | $643.61 | 1 |
| TN | $606.45 | 1 |
| TX | $619.76–$689.80 | 8 |
| UT | $633.17 | 1 |
| VA | $647.55–$762.81 | 2 |
| VI | $670.14 | 1 |
| VT | $644.37 | 1 |
| WA | $684.97–$776.06 | 2 |
| WI | $622.51 | 1 |
| WV | $616.49 | 1 |
| WY | $656.84 | 1 |
How the 28226 rate is calculated
Each of 28226’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 · 28226
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.55Practice expense 14.39Malpractice 0.98
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28226
28226 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28226
Tendon release
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28226
Tendon release
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28226 without 50 · national office
$665.35
Tendon release
28226-50 · Bilateral: 150%
$998.03
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
28226 compared with similar codes
Compare codes
28226 vs 28225 vs 28222 vs 28232 vs 28200: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28225Tendon release
- 28225 represents flexor tendon release for a single tendon; 28226 is used when multiple flexor tendons are released.
- 28222Tendon release
- 28222 concerns extensor tendon adhesions. 28226 concerns adhesions affecting multiple flexor tendons.
- 28232Toe tendon incision
- 28232 is an open flexor tenotomy of a toe, involving tendon division. 28226 frees multiple flexor tendons from adhesions.
- 28200Foot tendon repair
- 28200 reports foot flexor tendon repair. Choose 28226 for adhesiolysis when the tendons are freed rather than repaired.
28226 billing questions
How is 28226 distinguished from 28225?
28226 describes release of multiple flexor tendons. Use 28225 for the corresponding single-tendon release.
Is this a tendon repair code?
No. This code is for freeing adhesions that restrict tendon glide, not repairing a torn tendon. The operative note should support adhesiolysis rather than repair.
Can a toe flexor tenotomy be reported as 28226?
A tenotomy cuts or divides a tendon, whereas 28226 describes freeing multiple flexor tendons from adhesions. Choose based on the actual procedure documented.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral work reported?
For a bilateral procedure, report modifier 50; Medicare pays the code at 150% under the supplied bilateral rule.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code, and 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
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