No office rate
Both reconstruct a hand tendon pulley. Choose 26500 when no tendon graft is used and 26502 when the reconstruction uses a tendon graft.
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CMS RVU26D · Effective 2026-10-01
26500 Pulley reconstruction Medicare reimbursement rates in Rhode Island
Reconstructs a deficient tendon pulley in the hand without a tendon graft, typically to control bowstringing and restore tendon tracking. Compare 26500 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 26500 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
$700.90
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 26500: Hand tendon pulley reconstruction
Reconstructs a deficient tendon pulley in the hand without a tendon graft, typically to control bowstringing and restore tendon tracking.
A hand surgeon reconstructs a damaged or deficient pulley that normally holds a flexor tendon close to the finger. The procedure may be considered when pulley failure causes the tendon to bow away from the phalanx and impairs tendon tracking. The reconstruction uses no tendon graft; the corresponding graft-based pulley reconstruction is a separate code. These cases are generally performed in an operating room, often by an orthopedic or plastic surgeon specializing in hand surgery.
Report the code for each tendon pulley reconstructed without a graft, and document the affected tendon, the pulley deficiency, the reconstructive work, and whether graft material was used. This major surgery 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 the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26500
- 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 RVU5.98 · 29%
- Practice expense (office) RVU13.31 · 65%
- Malpractice RVU1.28 · 6%
93
Medicare services in 2024 · #4932 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.
26500 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
A tendon transfer reroutes a tendon to change or restore its action. This code reconstructs the pulley that guides a tendon.
No office rate
Tenolysis frees a tendon restricted by adhesions; it does not reconstruct a deficient pulley.
Compare 26500 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
$700.90
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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 26500 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,621
- Code
- 26500
- Physician work
- 5.98
- Practice expense
- 13.31
- Malpractice
- 1.28
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.98 | × 1.019 | 6.0936 |
| Practice expense | 13.31 | × 1.033 | 13.7492 |
| Malpractice | 1.28 | × 0.892 | 1.1418 |
| Total RVUs | 20.9846 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$700.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.98 | 1.019 |
| Practice expense | 13.31 | 1.033 |
| Malpractice | 1.28 | 0.892 |
(5.98 × 1.019 + 13.31 × 1.033 + 1.28 × 0.892) × $33.4009 = $700.90
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.
26500 billing questions
How is this code distinguished from 26502?
This code describes pulley reconstruction without a tendon graft. Use 26502 when the pulley reconstruction uses a tendon graft.
Is the code reported per hand or per reconstructed pulley?
The service is reported for each tendon pulley reconstructed. Document the tendon and pulley treated.
Can modifier 50 be used for reconstruction on both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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?
Only when the medical necessity of the assistant 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.
2,61826497,,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
2,62026499,,Correction claw finger other,A,,8.94,14.61,NA,14.61,,1.91,25.46,25.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62126500,,Hand tendon reconstruction,A,,5.98,13.31,NA,13.31,,1.28,20.57,20.57,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62226502,,Hand tendon reconstruction,A,,7.13,13.68,NA,13.68,,1.50,22.31,22.31,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62326508,,Release thumb contracture,A,,6.03,12.13,NA,12.13,,1.04,19.20,19.20,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,62426510,,Thumb tendon transfer,A,,5.46,12.28,NA,12.28,,1.05,18.79,18.79,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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