No office rate
Both describe secondary zone II flexor tendon repair. Choose 26358 when the surgeon uses a free graft; this code is for repair without one.
On this page
CMS RVU26D · Effective 2026-10-01
26357 Flexor tendon repair Medicare reimbursement rates in Delaware
Reports secondary repair of a flexor tendon in finger zone II, without a free graft, when the surgeon addresses an earlier tendon injury. Compare 26357 office and facility rates across CMS payment localities in Delaware.
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 26357 in Delaware?
Delaware 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
$842.47
1 of 1 localities have a supported rate.
Payment area: Delaware
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 26357: Secondary zone II flexor tendon repair
Reports secondary repair of a flexor tendon in finger zone II, without a free graft, when the surgeon addresses an earlier tendon injury.
This code is for secondary repair or advancement of a flexor tendon in zone II of a finger, without a free tendon graft. It is generally performed by a hand, orthopedic, or plastic surgeon in an operating room when the tendon injury is being treated as a secondary repair rather than a primary repair. The operative note should identify the affected tendon and finger, the zone, and the secondary nature of the repair. A repair that uses a free graft follows a different code path.
Report the code for each tendon repaired, with documentation supporting zone II, secondary repair, and the absence of a free graft. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 26357
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.73 · 42%
- Practice expense (office) RVU12.54 · 49%
- Malpractice RVU2.28 · 9%
94
Medicare services in 2024 · #4926 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.
26357 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
26352 describes primary zone II repair without a free graft. This code applies when the repair is secondary.
No office rate
26356 describes primary zone II repair with a free graft. This code is for secondary repair without a free graft.
Compare 26357 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
Delaware →
Office / nonfacility
Unavailable
Facility
$842.47
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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 26357 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,578
- Code
- 26357
- Physician work
- 10.73
- Practice expense
- 12.54
- Malpractice
- 2.28
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.73 | × 1.005 | 10.7836 |
| Practice expense | 12.54 | × 0.988 | 12.3895 |
| Malpractice | 2.28 | × 0.899 | 2.0497 |
| Total RVUs | 25.2229 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$842.47
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.73 | 1.005 |
| Practice expense | 12.54 | 0.988 |
| Malpractice | 2.28 | 0.899 |
(10.73 × 1.005 + 12.54 × 0.988 + 2.28 × 0.899) × $33.4009 = $842.47
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.
26357 billing questions
How does this differ from a primary flexor tendon repair?
This code is for a secondary repair in zone II. Use a primary-repair code when the procedure is documented as primary, selecting the code that matches the zone and graft use.
When is a graft code used instead?
Use the corresponding secondary-repair code when the surgeon uses a free tendon graft. This code describes secondary repair without a free graft.
How many units are reported when more than one tendon is repaired?
The code is reported for each tendon repaired. The operative report should identify the tendons treated and support the applicable zone and repair type.
Can modifier 50 be used for repairs on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code; the descriptor or anatomy makes modifier 50 unsuitable.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
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 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.
2,57526350,,Repair finger/hand tendon,A,,6.05,14.88,NA,14.88,,1.19,22.12,22.12,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57626352,,Repair/graft hand tendon,A,,7.67,14.94,NA,14.94,,1.48,24.09,24.09,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57726356,,Repair finger/hand tendon,A,,9.32,11.45,NA,11.45,,1.79,22.56,22.56,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57826357,,Repair finger/hand tendon,A,,10.73,12.54,NA,12.54,,2.28,25.55,25.55,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57926358,,Repair/graft hand tendon,A,,12.29,13.04,NA,13.04,,2.61,27.94,27.94,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58026370,,Repair finger/hand tendon,A,,7.10,14.31,NA,14.31,,1.34,22.75,22.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58126372,,Repair/graft hand tendon,A,,8.78,16.23,NA,16.23,,1.87,26.88,26.88,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503