Billing code 26437: Tendon realignmentMedicare rate & RVUs in Ohio
Reports surgical repositioning of a hand or finger extensor tendon when its course is abnormal and realignment is needed to restore tracking.
CMS doesn’t publish an office rate for 26437 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 26437 covers
A hand surgeon repositions an extensor tendon in the hand or finger so it follows its intended path, such as when it shifts off track near a finger joint. The operation may include stabilizing the tendon in its corrected position. This is a distinct goal from repairing a torn tendon, releasing a contracted tendon, or changing tendon length. It is generally performed in an operating-room setting by an orthopedic or plastic surgeon with hand-surgery expertise.
Report the service for each tendon realigned, with the operative note identifying the tendon, site, abnormal tracking, and corrective work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the treated side rather than using modifier 50. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
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.
26437 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $613.65 |
How the 26437 rate is calculated
Each of 26437’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 26437
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.84Practice expense 12.49Malpractice 1.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26437
26437 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26437
Tendon realignment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26437
Tendon realignment
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26437 without 51 · national facility
$649.65
Tendon realignment
26437-51 · Second procedure: 50%
$324.83
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
26437 compared with similar codes
Compare codes
26437 vs 26410 vs 26440 vs 26476 vs 26477: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26410Hand tendon repair
- 26437 repositions an extensor tendon that is tracking abnormally; 26410 describes repair of a hand tendon injury or defect.
- 26440Flexor tenolysis
- 26437 corrects tendon alignment. Choose 26440 when the procedure releases a restricted tendon rather than repositioning it.
- 26476Tendon lengthening
- 26476 is for lengthening a tendon. It is not the realignment service when the problem is the tendon’s path rather than its length.
- 26477Tendon shortening
- 26477 addresses tendon shortening. Use 26437 when the operative work restores tendon tracking without shortening it.
26437 billing questions
When should I report realignment rather than tendon repair?
Use 26437 when the operative objective is to reposition an extensor tendon onto its intended path. A tendon defect or tear repaired with sutures is a different service, such as the hand tendon repair represented by 26410.
Is this reported for each tendon?
Yes. The code is reported per tendon realigned; the operative note should identify each tendon and describe the correction.
Should modifier 50 be used for both hands?
No. The CMS bilateral adjustment is inappropriate for this code. Report the actual operative side and documented tendon work.
Can an assistant surgeon be billed?
Medicare's statutory restriction bars assistant-at-surgery payment for this service. Co-surgeon and team-surgery billing are also not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The same-session multiple-procedure reduction may affect payment when other procedures are performed.
What documentation supports 26437?
Document the tendon and hand or finger site, the abnormal tendon course or tracking, and the operative steps that reposition it. The record should distinguish realignment from repair, release, or lengthening.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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