CPT code 26445: Tendon release2026 Medicare rate & RVUs in Texas
Reports surgical release of adhesions restricting an extensor tendon in the hand or finger, typically when limited tendon glide persists after injury or surgery.
CMS doesn’t publish an office rate for 26445 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 26445 covers
Code 26445 represents surgical tenolysis of an extensor tendon in the hand or finger. A hand surgeon may perform it when scar tissue limits tendon glide and active movement, such as after a tendon injury, prior operation, or immobilization. The operative goal is to free the tendon from adhesions while preserving its function; this is different from repairing a torn tendon. The service is commonly performed in an operating room or outpatient surgery setting.
Select this code for the extensor tendon release and site documented in the operative report. Documentation should identify the affected tendon or tendons, the hand or finger location, the adhesions restricting motion, and the release performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred by statutory restriction, and 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 26445 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 | $627.09 |
| Beaumont | Unavailable | $564.02 |
| Brazoria | Unavailable | $596.06 |
| Dallas | Unavailable | $600.53 |
| Fort Worth | Unavailable | $596.57 |
| Galveston | Unavailable | $598.26 |
| Houston | Unavailable | $613.45 |
| Rest Of Texas | Unavailable | $580.16 |
How the 26445 rate is calculated
Each of 26445’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 · 26445
RVUs × geographic indexes × conversion factor
Work4.34
4.34 RVUs× 1.000 GPCI
Practice expense12.94
12.94 RVUs× 1.000 GPCI
Malpractice0.83
0.83 RVUs× 1.000 GPCI
Adjusted RVUs
18.1100
Conversion factor
$33.4009
Medicare rate
$604.89
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26445
26445 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26445
Tendon release
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 26445
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26445 without 51 · national facility
$604.89
Tendon release
26445-51 · Second procedure: 50%
$302.45
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%).
26445 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26440Flexor tenolysis
- Choose 26445 for extensor tendon adhesions in the hand or finger; 26440 concerns flexor tendon release in the palm or finger.
- 26449Tendon release
- Both address extensor tendon adhesions, but 26449 is for the forearm or wrist; 26445 is for the hand or finger.
- 26410Hand tendon repair
- Use 26410 when a hand tendon is repaired. Code 26445 describes freeing an extensor tendon restricted by adhesions, not repairing a tendon injury.
26445 billing questions
How does this differ from code 26440?
Code 26445 is for extensor tendon adhesions in the hand or finger. Code 26440 addresses flexor tendon release in the palm or finger.
When is code 26449 a closer choice?
Use 26449 when the extensor tendon release is in the forearm or wrist. Code 26445 is for the hand or finger.
Is this code for tendon repair?
No. It represents freeing an extensor tendon restricted by adhesions. A repair code is considered when the tendon itself is injured and repaired.
What operative documentation supports reporting it?
Document the extensor tendon and hand or finger site, the adhesions limiting excursion, and the release performed. The operative note should distinguish this work from tendon repair.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.
How do the global and assistant-surgery rules affect billing?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. Assistant-at-surgery payment is barred by statutory restriction; 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
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