Billing code 26357: Flexor tendon repairMedicare rate & RVUs in Utah

Reports secondary repair of a flexor tendon in finger zone II, without a free graft, when the surgeon addresses an earlier tendon injury.

CMS RVU26DEffective Oct 1, 20261 payment locality94 Medicare services in 2024

CMS doesn’t publish an office rate for 26357 in Utah.

—Office (non-facility)
$820.49Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 26357 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 26357 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 26357 covers

This code is for secondary repair or advancement of a flexor tendon in zone II of a finger, without a free tendon graft. It is generally performed by a hand, orthopedic, or plastic surgeon in an operating room when the tendon injury is being treated as a secondary repair rather than a primary repair. The operative note should identify the affected tendon and finger, the zone, and the secondary nature of the repair. A repair that uses a free graft follows a different code path.

Report the code for each tendon repaired, with documentation supporting zone II, secondary repair, and the absence of a free graft. The service 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 one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be made; 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.

26357 in Utah

26357 office and facility rates by payment locality
Payment localityOfficeFacility
UtahUnavailable$820.49

How the 26357 rate is calculated

Each of 26357’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 · 26357

RVUs × geographic indexes × conversion factor

Work10.73

10.73 RVUs× 1.000 GPCI

Practice expense12.54

12.54 RVUs× 1.000 GPCI

Malpractice2.28

2.28 RVUs× 1.000 GPCI

Adjusted RVUs

25.5500

Conversion factor

$33.4009

Medicare rate

$853.39

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26357

26357 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26357

Flexor tendon repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26357

Flexor 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26357 without 51 · national facility

$853.39

Flexor tendon repair

26357-51 · Second procedure: 50%

$426.70

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%).

When to use modifier 51

26357 compared with similar codes

Compare codes · National

4 codes, side by side

  • 26357

    Flexor tendon repair10.73 wRVU

    Not priced

  • 26358

    Hand tendon repair12.29 wRVU

    Not priced

  • 26352

    Tendon repair7.67 wRVU

    Not priced

  • 26356

    Flexor tendon repair9.32 wRVU

    Not priced

How to choose

26358Hand tendon repair
Both describe secondary zone II flexor tendon repair. Choose 26358 when the surgeon uses a free graft; this code is for repair without one.
26352Tendon repair
26352 describes primary zone II repair without a free graft. This code applies when the repair is secondary.
26356Flexor tendon repair
26356 describes primary zone II repair with a free graft. This code is for secondary repair without a free graft.

26357 billing questions

How does this differ from a primary flexor tendon repair?

This code is for a secondary repair in zone II. Use a primary-repair code when the procedure is documented as primary, selecting the code that matches the zone and graft use.

When is a graft code used instead?

Use the corresponding secondary-repair code when the surgeon uses a free tendon graft. This code describes secondary repair without a free graft.

How many units are reported when more than one tendon is repaired?

The code is reported for each tendon repaired. The operative report should identify the tendons treated and support the applicable zone and repair type.

Can modifier 50 be used for repairs on both hands?

No. CMS identifies bilateral adjustment as inappropriate for this code; the descriptor or anatomy makes modifier 50 unsuitable.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. 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
RVUs for 26357PPRRVU2026_Oct_nonQPP.csv, line 2,578 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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