No office rate
Use 26350 for primary flexor tendon repair without a free graft. This code is for secondary repair without a free graft.
On this page
CMS RVU26D · Effective 2026-10-01
26356 Flexor tendon repair Medicare reimbursement rates in Iowa
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. Compare 26356 office and facility rates across CMS payment localities in Iowa.
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 26356 in Iowa?
Iowa 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
$684.96
1 of 1 localities have a supported rate.
Payment area: Iowa
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 26356: Secondary flexor tendon repair without graft
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.
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.
CMS billing rules for 26356
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.32 · 41%
- Practice expense (office) RVU11.45 · 51%
- Malpractice RVU1.79 · 8%
1.2K
Medicare services in 2024 · #2846 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.
26356 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
26352 describes primary flexor tendon repair using a free graft. This code describes secondary repair without a free graft.
No office rate
Both are in the flexor tendon repair family; check the full code descriptors to distinguish the applicable secondary repair method.
Compare 26356 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
Iowa →
Office / nonfacility
Unavailable
Facility
$684.96
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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 26356 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,577
- Code
- 26356
- Physician work
- 9.32
- Practice expense
- 11.45
- Malpractice
- 1.79
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.32 | × 1.000 | 9.3200 |
| Practice expense | 11.45 | × 0.915 | 10.4767 |
| Malpractice | 1.79 | × 0.397 | 0.7106 |
| Total RVUs | 20.5074 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$684.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.32 | 1 |
| Practice expense | 11.45 | 0.915 |
| Malpractice | 1.79 | 0.397 |
(9.32 × 1 + 11.45 × 0.915 + 1.79 × 0.397) × $33.4009 = $684.96
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.
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 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.
2,57426341,,Manipulat palm cord post inj,A,,0.89,2.66,,1.13,,0.17,3.72,2.19,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57526350,,Repair finger/hand tendon,A,,6.05,14.88,NA,14.88,,1.19,22.12,22.12,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57626352,,Repair/graft hand tendon,A,,7.67,14.94,NA,14.94,,1.48,24.09,24.09,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57726356,,Repair finger/hand tendon,A,,9.32,11.45,NA,11.45,,1.79,22.56,22.56,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57826357,,Repair finger/hand tendon,A,,10.73,12.54,NA,12.54,,2.28,25.55,25.55,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,57926358,,Repair/graft hand tendon,A,,12.29,13.04,NA,13.04,,2.61,27.94,27.94,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58026370,,Repair finger/hand tendon,A,,7.10,14.31,NA,14.31,,1.34,22.75,22.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136