Billing code 28226: Tendon releaseMedicare rate & RVUs in Oklahoma

Open tenolysis of multiple foot or toe flexor tendons frees restricted tendon glide when adhesions limit motion after injury or prior surgery.

CMS RVU26DEffective Oct 1, 20261 payment locality83 Medicare services in 2024

Medicare pays $606.62 for 28226 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.

$606.62Office (non-facility)
$361.44Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28226 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oklahoma
  2. What 28226 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 28226 covers

This procedure surgically frees adhesions restricting the glide of multiple flexor tendons in the foot or toes. An orthopedic or podiatric surgeon typically performs it in an operating room when scar tissue limits tendon excursion, often after prior trauma or surgery. The operative work is directed at freeing the tendons, rather than repairing a tendon rupture or cutting a tendon to correct deformity.

Report the code when the surgeon documents open adhesiolysis involving multiple flexor tendons; the operative note should identify the tendons treated and the adhesion release performed. A release of a single flexor tendon is distinguished by the neighboring single-tendon code. Medicare assigns 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. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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.

28226 in Oklahoma

28226 office and facility rates by payment locality
Payment localityOfficeFacility
Oklahoma$606.62$361.44

How the 28226 rate is calculated

Each of 28226’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 · 28226

RVUs × geographic indexes × conversion factor

Work4.55

4.55 RVUs× 1.000 GPCI

Practice expense14.39

14.39 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

19.9200

Conversion factor

$33.4009

Medicare rate

$665.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 28226

28226 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28226

Tendon release

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28226

Tendon release

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28226 without 50 · national office

$665.35

Tendon release

28226-50 · Bilateral: 150%

$998.03

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

28226 compared with similar codes

Compare codes · National

5 codes, side by side

  • 28226

    Tendon release4.55 wRVU

    $665.35

  • 28225

    Tendon release3.69 wRVU

    $410.50−$254.85

  • 28222

    Tendon release5.62 wRVU

    $543.43−$121.92

  • 28232

    Toe tendon incision3.42 wRVU

    $374.09−$291.26

  • 28200

    Foot tendon repair4.62 wRVU

    $504.35−$161.00

How to choose

28225Tendon release
28225 represents flexor tendon release for a single tendon; 28226 is used when multiple flexor tendons are released.
28222Tendon release
28222 concerns extensor tendon adhesions. 28226 concerns adhesions affecting multiple flexor tendons.
28232Toe tendon incision
28232 is an open flexor tenotomy of a toe, involving tendon division. 28226 frees multiple flexor tendons from adhesions.
28200Foot tendon repair
28200 reports foot flexor tendon repair. Choose 28226 for adhesiolysis when the tendons are freed rather than repaired.

28226 billing questions

How is 28226 distinguished from 28225?

28226 describes release of multiple flexor tendons. Use 28225 for the corresponding single-tendon release.

Is this a tendon repair code?

No. This code is for freeing adhesions that restrict tendon glide, not repairing a torn tendon. The operative note should support adhesiolysis rather than repair.

Can a toe flexor tenotomy be reported as 28226?

A tenotomy cuts or divides a tendon, whereas 28226 describes freeing multiple flexor tendons from adhesions. Choose based on the actual procedure documented.

What postoperative care is included?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral work reported?

For a bilateral procedure, report modifier 50; Medicare pays the code at 150% under the supplied bilateral rule.

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this code, and 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 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
RVUs for 28226PPRRVU2026_Oct_nonQPP.csv, line 3,154 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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