No office rate
Use 26494 for the multiple-tendon thumb reconstruction when no free graft is used. The free graft is the key distinction for 26496.
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CMS RVU26D · Effective 2026-10-01
26496 Thumb tendon transfer Medicare reimbursement rates in Delaware
Reports operative transfer or transplantation of multiple thumb tendons using a free graft to restore thumb motion or function. Compare 26496 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 26496 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
$869.57
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 26496: Multiple thumb tendon transfer with free graft
Reports operative transfer or transplantation of multiple thumb tendons using a free graft to restore thumb motion or function.
This code represents operative transfer or transplantation involving multiple thumb tendons with a free graft. The surgeon redirects tendon function and uses a graft to bridge or augment the reconstruction. It may be performed by a hand or orthopedic surgeon for traumatic tendon loss or chronic dysfunction that impairs thumb movement. The operative report should establish the thumb tendons involved and describe the graft and reconstruction performed.
Select this code when the documented procedure involves multiple thumb tendons and a free graft; a single tendon or a reconstruction without a free graft points to a different code in the family. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26496
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.54 · 36%
- Practice expense (office) RVU14.79 · 56%
- Malpractice RVU2.04 · 8%
90
Medicare services in 2024 · #4957 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.
26496 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
This is the single-tendon thumb reconstruction with a free graft; 26496 is for multiple thumb tendons with a free graft.
No office rate
This code addresses tendon transfer or transplantation in the carpometacarpal area or dorsum of the hand. Choose 26496 for the multiple-tendon thumb procedure with a free graft.
No office rate
This code concerns finger tendon transfer. Code 26496 is the thumb-specific multiple-tendon reconstruction with a free graft.
Compare 26496 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
$869.57
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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 26496 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,617
- Code
- 26496
- Physician work
- 9.54
- Practice expense
- 14.79
- Malpractice
- 2.04
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.54 | × 1.005 | 9.5877 |
| Practice expense | 14.79 | × 0.988 | 14.6125 |
| Malpractice | 2.04 | × 0.899 | 1.8340 |
| Total RVUs | 26.0342 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$869.57
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.54 | 1.005 |
| Practice expense | 14.79 | 0.988 |
| Malpractice | 2.04 | 0.899 |
(9.54 × 1.005 + 14.79 × 0.988 + 2.04 × 0.899) × $33.4009 = $869.57
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.
26496 billing questions
How does this code differ from 26494?
Both concern multiple thumb tendons, but 26496 is selected when the reconstruction uses a free graft. Code 26494 describes the multiple-tendon alternative without a free graft.
What documentation supports reporting this code?
The operative report should identify the thumb tendons treated, describe the transfer or transplant, and document use of a free graft. It should make clear that multiple tendons were involved.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,61426490,,Revise thumb tendon,A,,8.39,14.43,NA,14.43,,1.77,24.59,24.59,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61526492,,Tendon transfer with graft,A,,9.59,15.38,NA,15.38,,2.05,27.02,27.02,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61626494,,Hand tendon/muscle transfer,A,,8.44,14.44,NA,14.44,,1.79,24.67,24.67,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61726496,,Revise thumb tendon,A,,9.54,14.79,NA,14.79,,2.04,26.37,26.37,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61826497,,Finger tendon transfer,A,,9.52,14.78,NA,14.78,,2.04,26.34,26.34,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61926498,,Finger tendon transfer,A,,13.85,16.73,NA,16.73,,2.95,33.53,33.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62026499,,Correction claw finger other,A,,8.94,14.61,NA,14.61,,1.91,25.46,25.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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