Secondary repair of the profundus (deep flexor) tendon with an intact superficialis tendon, performed using a free graft harvested during the same operative session.

Verified May 8, 2026 · 6 sources ↓

Medicare: $897.82
Total RVUs: 26.88
Global, days: 90
Region: Hand

Drawn from CMSAAPCAbosEatonhandCgsmedicare

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Specify that this is a secondary repair — document timing relative to original injury or prior surgical repair
Confirm intact superficialis tendon intraoperatively and note it explicitly in the operative report
Identify which finger and which tendon by name — zone, digit number, and laterality (LT/RT)
Document graft source, size, and harvest technique since graft acquisition is included in 26372
Record pre-op passive and active ROM and grip strength to support medical necessity
Note mechanism of original injury and reason primary repair was not performed or failed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26372 describes a secondary profundus tendon repair in a finger where the superficialis (sublimis) tendon remains intact. Secondary means the repair is performed days to weeks after the original injury — either because primary repair was delayed or because a prior repair failed. The procedure includes harvesting the free graft, so do not bill a separate graft-harvest code. Each tendon repaired is reported separately, with each additional tendon on the same hand requiring modifier 51.

The intact superficialis tendon is what distinguishes 26372 from codes in the zone-2 family (26350–26358). If the superficialis is also disrupted, those zone-2 codes apply instead. If the profundus is repaired secondarily without a graft, use 26373. If the repair is primary, use 26370. Getting that clinical distinction documented — intact vs. disrupted superficialis, primary vs. secondary timing — is what separates a clean claim from an audit flag.

With a 90-day global period, all routine follow-up through day 90 is included. Unrelated E/M visits in that window need modifier 24. A staged or planned secondary procedure in the global period takes modifier 58; an unplanned return for a related complication uses modifier 78.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.78
Practice expense RVU	16.23
Malpractice RVU	1.87
Total RVU	26.88
Medicare national rate	$897.82
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$897.82
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 26372 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing documentation that the superficialis tendon was intact — payers use this to dispute code selection over zone-2 codes
Billing a separate graft-harvest code alongside 26372 — graft procurement is bundled into the descriptor
Failing to append LT or RT, causing laterality-based claim rejection or edit
Reporting 26372 for a primary repair — 'secondary' must be established by operative note timing
Billing multiple tendons on the same claim line without modifier 51 on each additional unit

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What makes this a secondary repair versus primary?

Secondary means repair is performed at least several days after the original injury or after a prior repair attempt. The operative note must establish the timeline — date of injury, any prior surgery, and current operative date.

02Can I bill a separate code for harvesting the graft?

No. The descriptor for 26372 explicitly includes obtaining the graft. Billing a separate graft-harvest code alongside 26372 will trigger an NCCI bundling denial.

03If I repair two profundus tendons in different fingers during the same session, how do I bill?

Report 26372 for the first tendon, then 26372 again with modifier 51 for each additional tendon. Each tendon is a separate unit; each line must include the appropriate digit-level documentation.

04What code applies if the superficialis is also torn?

If the superficialis is disrupted, the zone-2 family applies — specifically 26358 for secondary flexor tendon repair with free graft in zone 2. The intact superficialis is a hard clinical criterion for 26372.

05Does the 90-day global period include tendon therapy visits?

Routine post-op visits by the operating surgeon are included. Therapy services by a separate PT or OT are not in the surgical global and bill independently. An E/M by the surgeon for an unrelated condition needs modifier 24.

06Can 26372 be performed in an ASC?

Yes. ASC and HOPD payment rates differ materially — see the Site of Service comparison on this page. The clinical and documentation rules are identical regardless of setting.

07When would modifier 22 apply to 26372?

Modifier 22 applies when the procedure is substantially more work than typical — for example, dense adhesions from a prior failed repair requiring extensive tenolysis before grafting. Document the additional time, complexity, and why it exceeded the standard procedure.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the key clinical details that define 26372: whether the superficialis is intact, the secondary timing of the repair relative to injury or prior surgery, the graft source and harvest site, the specific digit and zone, and intraoperative confirmation of tendon continuity. That granularity prevents the most common denial — a payer claiming insufficient documentation to distinguish 26372 from a zone-2 code or from a primary repair.

See how Mira captures CPT 26372 documentation