Billing code 26356: Flexor tendon repairMedicare rate & RVUs in Florida

Reports secondary repair of a flexor tendon in a finger or hand when the tendon is repaired without a free graft, counted for each tendon.

CMS RVU26DEffective Oct 1, 20263 payment localities1.2K Medicare services in 2024

CMS doesn’t publish an office rate for 26356 in Florida.

—Office (non-facility)
$766.77–$860.62Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 26356 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 26356 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 26356 covers

A hand surgeon typically reports this service when performing secondary repair of a flexor tendon in a finger or hand, such as a delayed repair where the tendon can be rejoined without inserting a free tendon graft. The operation may take place in a hospital or ambulatory surgery center. The operative note should identify the flexor tendon and site, establish that this is a secondary rather than primary repair, and describe the repair method and each tendon treated.

Report one unit for each tendon repaired under this code. Distinguish it from primary repair and from secondary repair that uses a free graft. Medicare assigns the procedure a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for it, and 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 26356 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

26356 office and facility rates by payment locality
Payment localityOfficeFacility
Fort LauderdaleUnavailable$806.80
MiamiUnavailable$860.62
Rest Of FloridaUnavailable$766.77

How the 26356 rate is calculated

Each of 26356’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 · 26356

RVUs × geographic indexes × conversion factor

Work9.32

9.32 RVUs× 1.000 GPCI

Practice expense11.45

11.45 RVUs× 1.000 GPCI

Malpractice1.79

1.79 RVUs× 1.000 GPCI

Adjusted RVUs

22.5600

Conversion factor

$33.4009

Medicare rate

$753.52

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26356

26356 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26356

Flexor tendon repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26356

Flexor tendon repair

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26356 without 51 · national facility

$753.52

Flexor tendon repair

26356-51 · Second procedure: 50%

$376.76

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%).

When to use modifier 51

26356 compared with similar codes

Compare codes · National

4 codes, side by side

  • 26356

    Flexor tendon repair9.32 wRVU

    Not priced

  • 26350

    Flexor tendon repair6.05 wRVU

    Not priced

  • 26352

    Tendon repair7.67 wRVU

    Not priced

  • 26357

    Flexor tendon repair10.73 wRVU

    Not priced

How to choose

26350Flexor tendon repair
Use 26350 for primary flexor tendon repair without a free graft. This code is for secondary repair without a free graft.
26352Tendon repair
26352 describes primary flexor tendon repair using a free graft. This code describes secondary repair without a free graft.
26357Flexor tendon repair
Both are in the flexor tendon repair family; check the full code descriptors to distinguish the applicable secondary repair method.

26356 billing questions

How does this differ from primary flexor tendon repair?

This code is for secondary repair. Use a primary-repair code when the operation is the initial repair rather than a secondary procedure.

When is a grafted repair coded instead?

Use the applicable graft code when a free tendon graft is used. Document whether a graft was used and how the tendon was repaired.

How many units should be reported?

Report one unit for each tendon repaired under this code. The operative report should identify the tendon or tendons treated.

Can modifier 50 be used for repairs on both hands?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be paid for this procedure?

Medicare does not pay an assistant at surgery for this code. 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
RVUs for 26356PPRRVU2026_Oct_nonQPP.csv, line 2,577 (RVU26D)

Open CMS sourceHow we calculate rates

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