No office rate
Choose 26479 for shortening an extensor tendon of the hand or finger; 26477 is for shortening a flexor tendon.
On this page
CMS RVU26D · Effective 2026-10-01
26479 Tendon shortening Medicare reimbursement rates in Guam
Shortens an extensor tendon in the hand or finger when excess tendon length needs correction to restore appropriate tension and function. Compare 26479 office and facility rates across CMS payment localities in Guam.
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 26479 in Guam?
Guam 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
$719.37
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 26479: Hand extensor tendon shortening
Shortens an extensor tendon in the hand or finger when excess tendon length needs correction to restore appropriate tension and function.
A hand surgeon shortens an extensor tendon in the hand or finger to correct excessive tendon length and improve tendon tension or motion. The operation may be selected when the documented problem is addressed by shortening the tendon itself, rather than by releasing it, lengthening it, or changing its position. The operative report should identify the treated tendon and hand or finger, describe the shortening performed, and connect the procedure to the functional problem being treated.
Report the service for each tendon shortened, with documentation supporting the tendon and procedure performed. 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 26479
- 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 RVU5.76 · 28%
- Practice expense (office) RVU13.25 · 65%
- Malpractice RVU1.23 · 6%
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.
26479 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
26479 shortens the tendon; 26478 is a lengthening procedure. The operative objective and work performed determine the choice.
No office rate
Use 26479 when the tendon is shortened. Code 26437 describes tendon realignment, where repositioning rather than shortening is the correction.
Compare 26479 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$719.37
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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 26479 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,609
- Code
- 26479
- Physician work
- 5.76
- Practice expense
- 13.25
- Malpractice
- 1.23
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.76 | × 1.000 | 5.7600 |
| Practice expense | 13.25 | × 1.137 | 15.0653 |
| Malpractice | 1.23 | × 0.579 | 0.7122 |
| Total RVUs | 21.5374 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$719.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.76 | 1 |
| Practice expense | 13.25 | 1.137 |
| Malpractice | 1.23 | 0.579 |
(5.76 × 1 + 13.25 × 1.137 + 1.23 × 0.579) × $33.4009 = $719.37
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.
26479 billing questions
How is this code distinguished from 26477?
This code describes shortening an extensor tendon of the hand or finger. Code 26477 is the corresponding shortening service for a flexor tendon.
What documentation supports reporting this service?
Document the hand or finger, the specific extensor tendon treated, the reason shortening was needed, and the operative work that shortened it.
Can modifier 50 be used when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the performed service according to the applicable claim instructions rather than using modifier 50.
How are other procedures in the same session paid?
CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures in the session are subject to a 50% reduction.
Is related postoperative care separately 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?
An assistant at surgery may be paid for this service. 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.
2,60626476,,Tendon lengthening,A,,5.22,13.07,NA,13.07,,1.12,19.41,19.41,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60726477,,Tendon shortening,A,,5.19,12.20,NA,12.20,,0.99,18.38,18.38,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60826478,,Lengthening of hand tendon,A,,5.82,12.54,NA,12.54,,1.13,19.49,19.49,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60926479,,Shortening of hand tendon,A,,5.76,13.25,NA,13.25,,1.23,20.24,20.24,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61026480,,Transplant hand tendon,A,,8.78,9.56,NA,9.56,,1.66,20.00,20.00,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61126483,,Transplant/graft hand tendon,A,,8.27,15.16,NA,15.16,,1.57,25.00,25.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61226485,,Transplant palm tendon,A,,7.69,15.00,NA,15.00,,1.47,24.16,24.16,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014