No office rate
Compare the operative technique and graft use. This code concerns a hand tendon or muscle transfer; 26492 is the grafted transfer option.
On this page
CMS RVU26D · Effective 2026-10-01
26494 Tendon transfer Medicare reimbursement rates in Missouri
Reports a hand tendon or muscle transfer that redirects an active unit to restore or rebalance movement after weakness or loss of function. Compare 26494 office and facility rates across CMS payment localities in Missouri.
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 26494 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$755.89–$800.97
3 of 3 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.
Where 26494 pays more and less in Missouri
Hand surgery
About 26494: Hand tendon or muscle transfer
Reports a hand tendon or muscle transfer that redirects an active unit to restore or rebalance movement after weakness or loss of function.
The surgeon redirects a functioning tendon or muscle unit to provide a movement that has been lost or is poorly balanced. Hand transfers may be considered when nerve injury, paralysis, or tendon damage leaves a patient unable to perform a useful motion. The operative report should identify the donor unit, its new attachment or route, the intended movement, and any graft used. This is a surgical service performed by a hand or orthopedic surgeon, typically in an operating room.
Select this code from the transfer performed and the operative anatomy, not simply from the diagnosis or the fact that a tendon was handled. Distinguish a transfer from tendon release, lengthening, shortening, or transplant, and use a more specific finger-transfer code when its defined procedure is performed. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 26494
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.44 · 34%
- Practice expense (office) RVU14.44 · 59%
- Malpractice RVU1.79 · 7%
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.
26494 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 26497 when the operation is the specified finger extensor transfer with intrinsic muscle release, rather than a hand transfer described by this code.
No office rate
Use 26498 for the specified finger flexor transfer with intrinsic muscle release; do not select it solely because a finger is weak.
No office rate
26480 describes a tendon transfer or transplant at the carpometacarpal area or dorsum of the hand. Choose by the documented procedure and site.
Compare 26494 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$793.20
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$800.97
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$755.89
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26494 billing questions
How is this distinguished from a tendon transplant?
A transfer redirects a functioning tendon or muscle unit to perform a different movement. A transplant or graft procedure involves a different operative method; follow the documented technique and the code that describes it.
When should a finger-specific transfer code be considered?
Consider 26497 or 26498 when the operation matches the finger tendon transfer and intrinsic muscle release described by that code. The operative details, not just the diagnosis of finger weakness, determine the choice.
Can modifier 50 be used for a transfer performed on both hands?
Modifier 50 is inappropriate for this code. Report the service according to the procedure performed and applicable claim instructions.
What documentation supports reporting this service?
Document the donor tendon or muscle, its new route or attachment, the movement being restored, and whether a graft was used. Include the affected hand and the operative findings that support the transfer.
How are other procedures performed in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are subject to a 50% reduction. The 90-day global period includes related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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.
2,61326489,,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
2,61426490,,Revise thumb tendon,A,,8.39,14.43,NA,14.43,,1.77,24.59,24.59,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61526492,,Tendon transfer with graft,A,,9.59,15.38,NA,15.38,,2.05,27.02,27.02,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61626494,,Hand tendon/muscle transfer,A,,8.44,14.44,NA,14.44,,1.79,24.67,24.67,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61726496,,Revise thumb tendon,A,,9.54,14.79,NA,14.79,,2.04,26.37,26.37,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61826497,,Finger tendon transfer,A,,9.52,14.78,NA,14.78,,2.04,26.34,26.34,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,61926498,,Finger tendon transfer,A,,13.85,16.73,NA,16.73,,2.95,33.53,33.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00