No office rate
Choose 26449 for extensor tendon adhesions in the forearm or wrist; choose 26445 when the release is in the hand or finger.
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CMS RVU26D · Effective 2026-10-01
26449 Tendon release Medicare reimbursement rates in Massachusetts
Surgical freeing of an extensor tendon in the forearm or wrist from adhesions that restrict its glide, reported for each tendon treated. Compare 26449 office and facility rates across CMS payment localities in Massachusetts.
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 26449 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$671.99–$730.18
2 of 2 localities have a supported rate.
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 26449: Extensor tendon tenolysis, forearm or wrist
Surgical freeing of an extensor tendon in the forearm or wrist from adhesions that restrict its glide, reported for each tendon treated.
This procedure frees an extensor tendon in the forearm or wrist from scar adhesions that limit tendon excursion and impair movement. A hand or orthopedic surgeon typically performs it when examination and operative findings support adhesions as the source of restricted tendon glide, such as after prior injury or tendon surgery. The work is tenolysis: freeing the tendon, rather than repairing, lengthening, or removing it.
Report the code for each extensor tendon treated, with documentation identifying the tendon and forearm or wrist location, the adhesions and functional restriction, and the release performed. It 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 other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26449
- 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 RVU8.38 · 42%
- Practice expense (office) RVU9.84 · 50%
- Malpractice RVU1.56 · 8%
427
Medicare services in 2024 · #3677 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.
26449 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
This code concerns an extensor tendon in the forearm or wrist. Code 26440 describes flexor tendon tenolysis in the palm or finger.
No office rate
Tenolysis frees adhesions restricting tendon glide; 26476 is used for tendon lengthening, not simply freeing an adherent tendon.
Compare 26449 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$730.18
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$671.99
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26449 billing questions
How is 26449 distinguished from 26445?
Both describe extensor tendon tenolysis, but 26449 is for the forearm or wrist and 26445 is for the hand or finger. Use the documented site of the tendon release.
Is this code for a flexor tendon release?
No. This code is for an extensor tendon in the forearm or wrist. Flexor tendon tenolysis in the palm or finger is reported from a separate code series.
How many units should be reported?
Report each extensor tendon treated, supported by the operative documentation. Identify the tendon and its location rather than relying only on the number of incisions.
Can modifier 50 be used for bilateral treatment?
No. Modifier 50 is inappropriate for this code under the CMS bilateral rule.
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?
Assistant-at-surgery payment is allowed only when medical necessity 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 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.
2,59726440,,Release palm/finger tendon,A,,5.03,13.25,NA,13.25,,0.96,19.24,19.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59826442,,Release palm & finger tendon,A,,9.51,17.42,NA,17.42,,1.84,28.77,28.77,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59926445,,Release hand/finger tendon,A,,4.34,12.94,NA,12.94,,0.83,18.11,18.11,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60026449,,Release forearm/hand tendon,A,,8.38,9.84,NA,9.84,,1.56,19.78,19.78,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60126450,,Incision of palm tendon,A,,3.70,9.35,NA,9.35,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60226455,,Incision of finger tendon,A,,3.67,9.38,NA,9.38,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60326460,,Incise hand/finger tendon,A,,3.49,9.29,NA,9.29,,0.65,13.43,13.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00