Billing code 26500: Pulley reconstructionMedicare rate & RVUs in Delaware
Reconstructs a deficient tendon pulley in the hand without a tendon graft, typically to control bowstringing and restore tendon tracking.
CMS doesn’t publish an office rate for 26500 in Delaware.
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 9 sections
What 26500 covers
A hand surgeon reconstructs a damaged or deficient pulley that normally holds a flexor tendon close to the finger. The procedure may be considered when pulley failure causes the tendon to bow away from the phalanx and impairs tendon tracking. The reconstruction uses no tendon graft; the corresponding graft-based pulley reconstruction is a separate code. These cases are generally performed in an operating room, often by an orthopedic or plastic surgeon specializing in hand surgery.
Report the code for each tendon pulley reconstructed without a graft, and document the affected tendon, the pulley deficiency, the reconstructive work, and whether graft material was used. This major surgery 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 the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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.
26500 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $678.40 |
How the 26500 rate is calculated
Each of 26500’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 · 26500
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.98Practice expense 13.31Malpractice 1.28
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26500
26500 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26500
Pulley reconstruction
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 · 26500
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26500 without 51 · national facility
$687.06
Pulley reconstruction
26500-51 · Second procedure: 50%
$343.53
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%).
26500 compared with similar codes
Compare codes
26500 vs 26502 vs 26510 vs 26440: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26502Pulley reconstruction
- Both reconstruct a hand tendon pulley. Choose 26500 when no tendon graft is used and 26502 when the reconstruction uses a tendon graft.
- 26510Tendon transfer
- A tendon transfer reroutes a tendon to change or restore its action. This code reconstructs the pulley that guides a tendon.
- 26440Flexor tenolysis
- Tenolysis frees a tendon restricted by adhesions; it does not reconstruct a deficient pulley.
26500 billing questions
How is this code distinguished from 26502?
This code describes pulley reconstruction without a tendon graft. Use 26502 when the pulley reconstruction uses a tendon graft.
Is the code reported per hand or per reconstructed pulley?
The service is reported for each tendon pulley reconstructed. Document the tendon and pulley treated.
Can modifier 50 be used for reconstruction on both hands?
No. CMS identifies bilateral adjustment 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.
When is assistant-at-surgery payment allowed?
Only when the medical necessity of the assistant is documented. 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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