No office rate
26437 repositions an extensor tendon that is tracking abnormally; 26410 describes repair of a hand tendon injury or defect.
On this page
CMS RVU26D · Effective 2026-10-01
26437 Tendon realignment Medicare reimbursement rates in Rhode Island
Reports surgical repositioning of a hand or finger extensor tendon when its course is abnormal and realignment is needed to restore tracking. Compare 26437 office and facility rates across CMS payment localities in Rhode Island.
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 26437 in Rhode Island?
Rhode Island 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
$663.08
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 26437: Hand or finger extensor tendon realignment
Reports surgical repositioning of a hand or finger extensor tendon when its course is abnormal and realignment is needed to restore tracking.
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.
CMS billing rules for 26437
- 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 RVU5.84 · 30%
- Practice expense (office) RVU12.49 · 64%
- Malpractice RVU1.12 · 6%
3.7K
Medicare services in 2024 · #2045 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.
26437 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
26437 corrects tendon alignment. Choose 26440 when the procedure releases a restricted tendon rather than repositioning it.
No office rate
26476 is for lengthening a tendon. It is not the realignment service when the problem is the tendon’s path rather than its length.
No office rate
26477 addresses tendon shortening. Use 26437 when the operative work restores tendon tracking without shortening it.
Compare 26437 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$663.08
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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 26437 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,596
- Code
- 26437
- Physician work
- 5.84
- Practice expense
- 12.49
- Malpractice
- 1.12
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.84 | × 1.019 | 5.9510 |
| Practice expense | 12.49 | × 1.033 | 12.9022 |
| Malpractice | 1.12 | × 0.892 | 0.9990 |
| Total RVUs | 19.8522 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$663.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.84 | 1.019 |
| Practice expense | 12.49 | 1.033 |
| Malpractice | 1.12 | 0.892 |
(5.84 × 1.019 + 12.49 × 1.033 + 1.12 × 0.892) × $33.4009 = $663.08
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.
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 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.
2,59326432,,Repair finger tendon,A,,4.06,11.40,NA,11.40,,0.79,16.25,16.25,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59426433,,Repair finger tendon,A,,4.58,11.53,NA,11.53,,0.89,17.00,17.00,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59526434,,Repair/graft finger tendon,A,,6.10,13.35,NA,13.35,,1.31,20.76,20.76,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59626437,,Realignment of tendons,A,,5.84,12.49,NA,12.49,,1.12,19.45,19.45,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59726440,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537