Billing code 26358: Hand tendon repairMedicare rate & RVUs in Texas
Reports operative repair or grafting of a hand tendon when the surgeon restores tendon continuity or function through the service represented by this code.
CMS doesn’t publish an office rate for 26358 in Texas.
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 26358 covers
A hand surgeon reports this service for an operation to repair or reconstruct a tendon in the hand, with a graft included when the procedure requires one. The work may address a tendon disrupted by injury or impaired by a defect that prevents direct repair. The operative report should identify the treated tendon, the hand site, the nature of the tendon problem, and the repair or graft technique. This code describes operative tendon work, not manipulation of a finger or removal of an implant.
Report the code that matches the operation documented; related codes distinguish other hand and finger tendon repair or graft services. The 90-day global period includes 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 adjustment is inappropriate for this code. An assistant at surgery may be paid; 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.
Where 26358 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $949.37 |
| Beaumont | Unavailable | $887.83 |
| Brazoria | Unavailable | $913.41 |
| Dallas | Unavailable | $922.79 |
| Fort Worth | Unavailable | $919.57 |
| Galveston | Unavailable | $918.46 |
| Houston | Unavailable | $966.23 |
| Rest Of Texas | Unavailable | $902.55 |
How the 26358 rate is calculated
Each of 26358’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 · 26358
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.29Practice expense 13.04Malpractice 2.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26358
26358 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26358
Hand tendon repair
| 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) | 2 | Paid. |
| 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 · 26358
Hand tendon repair
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
26358 without 51 · national facility
$933.22
Hand tendon repair
26358-51 · Second procedure: 50%
$466.61
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%).
26358 compared with similar codes
Compare codes
26358 vs 26320 vs 26340 vs 26390: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26320Implant removal
- 26320 reports removal of an implant from the hand. Code 26358 concerns hand tendon repair or graft work, not implant removal.
- 26340Finger manipulation
- 26340 describes manipulation of a finger under anesthesia. Use 26358 for the documented operative tendon repair or graft service instead.
- 26390Tendon revision
- 26390 concerns revision of a hand or finger tendon. Code 26358 represents the repair or graft service described by its operative documentation, not a revision service by default.
26358 billing questions
What documentation supports reporting this code?
The operative report should identify the hand tendon treated, the underlying tendon problem, and the repair or graft work performed. Document the method and the extent of the procedure.
How is this distinguished from nearby tendon repair codes?
Codes 26350, 26352, 26356, 26357, 26372, and 26392 identify other tendon repair or graft services. Choose the code whose full billing code descriptor matches the documented operation rather than relying on the shared short descriptor.
Can this code be reported with modifier 50?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used to report bilateral payment.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.
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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