No office rate
This code concerns graft-based reconstruction of a hand or finger tendon. Use 26410 when the documented hand tendon procedure matches its repair service instead.
On this page
CMS RVU26D · Effective 2026-10-01
26416 Tendon graft Medicare reimbursement rates in Virginia
Reports graft-based reconstruction of a hand or finger tendon when the operative repair requires tendon graft tissue rather than direct tendon repair. Compare 26416 office and facility rates across CMS payment localities in Virginia.
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 26416 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$868.87–$1013.94
2 of 2 localities have a supported rate.
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 26416: Hand or finger tendon graft reconstruction
Reports graft-based reconstruction of a hand or finger tendon when the operative repair requires tendon graft tissue rather than direct tendon repair.
A hand surgeon uses tendon graft tissue to reconstruct a damaged or deficient tendon in the hand or finger. This may be needed when trauma, tendon loss, or chronic damage leaves a gap or tissue that cannot be managed with a direct repair. The procedure is generally performed in an operating room by an orthopedic or plastic surgeon with hand-surgery expertise. The operative note should identify the tendon and site, the defect or damage being addressed, and the graft-based reconstruction performed.
Report the code when the documented procedure matches graft reconstruction, rather than a repair performed without graft tissue or an excision alone. Documentation should support the tendon involved, graft use, and the surgical work performed. Medicare assigns 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 26416
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.32 · 35%
- Practice expense (office) RVU15.56 · 58%
- Malpractice RVU1.98 · 7%
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.
26416 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Both codes concern hand tendon work involving repair or grafting. Choose based on the exact procedure documented and the code descriptor that matches it.
No office rate
This code describes a finger tendon repair option. Use 26416 when the operative report supports the graft-based reconstruction represented by this code.
No office rate
This is a neighboring finger tendon repair or graft code. Distinguish it from 26416 using the specific procedure performed and documented.
Compare 26416 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1013.94
Virginia →
Office / nonfacility
Unavailable
Facility
$868.87
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26416 billing questions
How does this differ from a tendon repair code?
Use this code for the graft-based reconstruction described by the operative report. A repair code applies when the documented work matches that repair procedure rather than this graft reconstruction.
Can the graft be billed separately?
The code represents the graft-based tendon procedure. Do not report a separate service for the graft work that is included in that procedure.
Should modifier 50 be used for both hands?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing 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.
2,58526410,,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
2,59026420,,Repair/graft finger tendon,A,,6.77,13.45,NA,13.45,,1.28,21.50,21.50,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59126426,,Repair finger/hand tendon,A,,6.16,6.92,NA,6.92,,1.17,14.25,14.25,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00