No office rate
Use 26483 for the corresponding dorsal hand or carpometacarpal tendon procedure when a free graft is used. This code applies when no free graft is used.
On this page
CMS RVU26D · Effective 2026-10-01
26480 Tendon transfer Medicare reimbursement rates in Guam
Reports rerouting a tendon in the dorsal hand or carpometacarpal region without a free graft to restore or redirect hand function. Compare 26480 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 26480 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
$688.42
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 26480: Dorsal hand tendon transfer without graft
Reports rerouting a tendon in the dorsal hand or carpometacarpal region without a free graft to restore or redirect hand function.
A hand surgeon reroutes or transplants a tendon in the carpometacarpal region or on the back of the hand, without using a free tendon graft. The procedure can redirect the pull of a functioning tendon to improve movement affected by tendon imbalance, injury, or loss of nerve function. It is typically performed in an operating room by an orthopedic or plastic surgeon specializing in hand surgery.
Report the service for the tendon transfer or transplant in this location and document the operative anatomy, tendon moved, new attachment or route, and absence of a free graft. The related code for the same region with a free graft is 26483; palm or finger procedures belong to different codes. This major surgery includes 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 reduced. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26480
- 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 RVU8.78 · 44%
- Practice expense (office) RVU9.56 · 48%
- Malpractice RVU1.66 · 8%
19.8K
Medicare services in 2024 · #1154 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.
26480 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
The site distinguishes the codes: 26485 covers palm or finger tendon work without a free graft, while this code covers the carpometacarpal region or back of the hand.
No office rate
26437 describes tendon realignment. This code is for relocating or transplanting a tendon to redirect its function.
Compare 26480 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
$688.42
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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 26480 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,610
- Code
- 26480
- Physician work
- 8.78
- Practice expense
- 9.56
- Malpractice
- 1.66
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.000 | 8.7800 |
| Practice expense | 9.56 | × 1.137 | 10.8697 |
| Malpractice | 1.66 | × 0.579 | 0.9611 |
| Total RVUs | 20.6109 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$688.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1 |
| Practice expense | 9.56 | 1.137 |
| Malpractice | 1.66 | 0.579 |
(8.78 × 1 + 9.56 × 1.137 + 1.66 × 0.579) × $33.4009 = $688.42
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.
26480 billing questions
How does this code differ from 26483?
This code describes tendon transfer or transplantation in the dorsal hand or carpometacarpal region without a free graft. Code 26483 is the corresponding option when a free graft is used.
When should a palm or finger tendon code be considered instead?
Choose based on the operative site. This code is for the carpometacarpal region or back of the hand; palm and finger procedures are represented by other codes, including 26485 and 26489.
What operative details support reporting this service?
Document the involved region, the tendon moved, its route or new attachment, and whether a free graft was used. The record should establish that the work is a tendon transfer or transplant rather than simple realignment.
Can modifier 50 be used when both hands are treated?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
When is an assistant-at-surgery payable?
Assistant-at-surgery payment is limited to cases with documentation of medical necessity. 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.
2,60726477,,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
2,61326489,,Transplant/graft palm tendon,A,,9.61,16.50,NA,16.50,,2.05,28.16,28.16,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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