No office rate
Both address flexor tendon adhesions in the palm and finger. Choose 26442 when secondary tenolysis includes a free tendon graft; 26440 is the choice without that graft work.
On this page
CMS RVU26D · Effective 2026-10-01
26442 Flexor tenolysis Medicare reimbursement rates in Alabama
Reports secondary release of adhesions limiting flexor tendon glide in the palm or finger when the procedure includes a free tendon graft. Compare 26442 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26442 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$861.54
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Hand surgery
About 26442: Secondary flexor tendon tenolysis with graft
Reports secondary release of adhesions limiting flexor tendon glide in the palm or finger when the procedure includes a free tendon graft.
This procedure addresses a flexor tendon in the palm or finger that remains tethered by scar tissue and cannot glide adequately, often after an earlier tendon injury or repair. The surgeon frees the tendon and uses a free tendon graft as part of the secondary reconstruction. Hand surgeons typically perform it in an operating room, with the operative report identifying the involved tendon, adhesion release, and graft work.
Report 26442 for the secondary flexor tenolysis with free graft; 26440 is the related choice for flexor tenolysis without that graft work. The record should support the affected tendon, the adhesions restricting excursion, and the graft used. CMS 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 others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 26442
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.51 · 33%
- Practice expense (office) RVU17.42 · 61%
- Malpractice RVU1.84 · 6%
2.4K
Medicare services in 2024 · #2311 by national volume
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.
26442 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
This code is for extensor tendon tenolysis in the hand or finger. Code 26442 concerns flexor tendon tenolysis with a free graft.
No office rate
This code addresses extensor tendon tenolysis involving the forearm or hand, rather than the palm-and-finger flexor tendon procedure reported with 26442.
No office rate
Use 26416 for hand or finger tendon grafting when graft reconstruction is the service performed; 26442 describes secondary flexor tenolysis with a free graft.
Compare 26442 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$861.54
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 26442 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,598
- Code
- 26442
- Physician work
- 9.51
- Practice expense
- 17.42
- Malpractice
- 1.84
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.51 | × 1.000 | 9.5100 |
| Practice expense | 17.42 | × 0.875 | 15.2425 |
| Malpractice | 1.84 | × 0.566 | 1.0414 |
| Total RVUs | 25.7939 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$861.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.51 | 1 |
| Practice expense | 17.42 | 0.875 |
| Malpractice | 1.84 | 0.566 |
(9.51 × 1 + 17.42 × 0.875 + 1.84 × 0.566) × $33.4009 = $861.54
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
26442 billing questions
How does 26442 differ from 26440?
Both concern flexor tendon tenolysis in the palm and finger. Use 26442 for the secondary procedure with a free tendon graft; use 26440 for tenolysis without that graft work.
Is the free tendon graft separately reported?
The graft is part of the service described by 26442. Document the graft and its role in the secondary tendon procedure.
Can modifier 50 be used for procedures on both hands?
No. CMS identifies modifier 50 as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Is an assistant surgeon or co-surgeon payable?
Medicare does not pay an assistant at surgery for 26442. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,59526434,,Repair/graft finger tendon,A,,6.10,13.35,NA,13.35,,1.31,20.76,20.76,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59626437,,Realignment of tendons,A,,5.84,12.49,NA,12.49,,1.12,19.45,19.45,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59726440,,Release palm/finger tendon,A,,5.03,13.25,NA,13.25,,0.96,19.24,19.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59826442,,Release palm & finger tendon,A,,9.51,17.42,NA,17.42,,1.84,28.77,28.77,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59926445,,Release hand/finger tendon,A,,4.34,12.94,NA,12.94,,0.83,18.11,18.11,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60026449,,Release forearm/hand tendon,A,,8.38,9.84,NA,9.84,,1.56,19.78,19.78,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60126450,,Incision of palm tendon,A,,3.70,9.35,NA,9.35,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515