No office rate
Choose 26410 for hand extensor tendon repair without a free graft; 26412 involves secondary repair with a free graft.
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CMS RVU26D · Effective 2026-10-01
26412 Tendon repair Medicare reimbursement rates in Tennessee
Reports secondary reconstruction of a hand extensor tendon using a free tendon graft when the repair requires graft material to restore continuity. Compare 26412 office and facility rates across CMS payment localities in Tennessee.
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 26412 in Tennessee?
Tennessee 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
$636.30
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 26412: Secondary hand extensor tendon repair with graft
Reports secondary reconstruction of a hand extensor tendon using a free tendon graft when the repair requires graft material to restore continuity.
This code covers secondary reconstruction of an extensor tendon in the hand when a free tendon graft is needed to bridge a defect or restore tendon length and continuity. It is generally performed by a hand, orthopedic, or plastic surgeon in an operating room, often for a delayed tendon injury or a tendon that cannot be repaired directly because of a gap or scarring. The graft may be harvested during the procedure; obtaining the graft is included in this service.
Report the code for each tendon treated, and document the hand tendon involved, the secondary nature of the repair, why direct repair was inadequate, and the graft used. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26412
- 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 RVU6.32 · 30%
- Practice expense (office) RVU13.29 · 64%
- Malpractice RVU1.21 · 6%
136
Medicare services in 2024 · #4625 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.
26412 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
26416 describes a tendon graft service. 26412 is the secondary hand tendon repair with graft incorporated into the reconstruction.
No office rate
26420 is the related graft repair code for a finger tendon. Use 26412 for the hand tendon service.
Compare 26412 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$636.30
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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 26412 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
2,586
- Code
- 26412
- Physician work
- 6.32
- Practice expense
- 13.29
- Malpractice
- 1.21
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.32 | × 1.000 | 6.3200 |
| Practice expense | 13.29 | × 0.909 | 12.0806 |
| Malpractice | 1.21 | × 0.537 | 0.6498 |
| Total RVUs | 19.0504 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$636.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.32 | 1 |
| Practice expense | 13.29 | 0.909 |
| Malpractice | 1.21 | 0.537 |
(6.32 × 1 + 13.29 × 0.909 + 1.21 × 0.537) × $33.4009 = $636.30
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.
26412 billing questions
When should 26412 be chosen instead of 26410?
Use 26412 when secondary repair of a hand extensor tendon requires a free graft. The no-free-graft repair is the distinguishing feature of 26410.
Is graft harvesting separately reported?
No. Obtaining the free graft is included in this repair.
How many units should be reported?
Report one unit for each tendon repaired with a free graft, supported by the operative report.
What should the operative note establish?
Document the tendon and hand treated, the secondary repair, why direct repair was insufficient, and the graft used.
Can modifier 50 be used for repairs on both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
When is assistant-at-surgery payment allowed?
Payment is allowed only when the record documents medical necessity. 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.
2,58326390,,Revise hand/finger tendon,A,,9.19,14.34,NA,14.34,,1.96,25.49,25.49,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58426392,,Repair/graft hand tendon,A,,10.24,16.70,NA,16.70,,2.18,29.12,29.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58526410,,Repair hand tendon,A,,4.65,12.37,NA,12.37,,0.90,17.92,17.92,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58626412,,Repair/graft hand tendon,A,,6.32,13.29,NA,13.29,,1.21,20.82,20.82,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58726415,,Excision hand/finger tendon,A,,8.30,14.89,NA,14.89,,1.76,24.95,24.95,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58826416,,Graft hand or finger tendon,A,,9.32,15.56,NA,15.56,,1.98,26.86,26.86,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,58926418,,Repair finger tendon,A,,4.36,13.58,NA,13.58,,0.85,18.79,18.79,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780