No office rate
Choose 26445 for extensor tendon adhesions in the hand or finger; 26440 concerns flexor tendon release in the palm or finger.
On this page
CMS RVU26D · Effective 2026-10-01
26445 Tendon release Medicare reimbursement rates in Washington
Reports surgical release of adhesions restricting an extensor tendon in the hand or finger, typically when limited tendon glide persists after injury or surgery. Compare 26445 office and facility rates across CMS payment localities in Washington.
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 26445 in Washington?
Washington 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
$623.06–$705.18
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 26445: Extensor tendon adhesion release
Reports surgical release of adhesions restricting an extensor tendon in the hand or finger, typically when limited tendon glide persists after injury or surgery.
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.
CMS billing rules for 26445
- 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 RVU4.34 · 24%
- Practice expense (office) RVU12.94 · 71%
- Malpractice RVU0.83 · 5%
2.6K
Medicare services in 2024 · #2270 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.
26445 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
Both address extensor tendon adhesions, but 26449 is for the forearm or wrist; 26445 is for the hand or finger.
No office rate
Use 26410 when a hand tendon is repaired. Code 26445 describes freeing an extensor tendon restricted by adhesions, not repairing a tendon injury.
Compare 26445 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$623.06
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$705.18
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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 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.
2,59626437,,Realignment of tendons,A,,5.84,12.49,NA,12.49,,1.12,19.45,19.45,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59726440,,Release palm/finger tendon,A,,5.03,13.25,NA,13.25,,0.96,19.24,19.24,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59826442,,Release palm & finger tendon,A,,9.51,17.42,NA,17.42,,1.84,28.77,28.77,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,59926445,,Release hand/finger tendon,A,,4.34,12.94,NA,12.94,,0.83,18.11,18.11,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60026449,,Release forearm/hand tendon,A,,8.38,9.84,NA,9.84,,1.56,19.78,19.78,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60126450,,Incision of palm tendon,A,,3.70,9.35,NA,9.35,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,60226455,,Incision of finger tendon,A,,3.67,9.38,NA,9.38,,0.69,13.74,13.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00