Secondary repair or advancement of the flexor digitorum profundus tendon in a finger where the superficialis tendon remains intact, performed without a free graft.

Verified May 8, 2026 · 5 sources ↓

Medicare: $868.42
Total RVUs: 26
Global, days: 90
Region: Hand

Drawn from AbosAAPCCMSAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Confirm this is a secondary (not primary, same-day-of-injury) repair — date of original injury or prior procedure must be documented.
State explicitly that no free graft was harvested or used; if graft was taken, 26372 applies instead.
Identify the specific finger(s) and tendon(s) repaired, including digit number and laterality (LT or RT).
Document that the superficialis tendon is intact and functional at the time of repair.
Describe the surgical technique — direct repair versus advancement — and the condition of the tendon stumps encountered.
Record intraoperative tendon excursion or tension assessment confirming repair integrity before closure.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 26373 covers a secondary (delayed, not same-day-of-injury) repair or advancement of the profundus tendon in a finger when the superficialis tendon is still functional and no tendon graft is harvested or implanted. The distinction between 26370 (primary), 26372 (secondary with free graft), and 26373 (secondary without free graft) is not cosmetic — auditors will flag a claim coded 26373 if the operative note describes obtaining or using graft tissue, which belongs under 26372. The descriptor applies per tendon, so multiple digits repaired on the same day are reported with additional units or separate line items, depending on payer policy.

The 90-day global period means the post-op hand therapy visits, dressing changes, and wound checks are bundled through day 90. Any evaluation or procedure unrelated to the tendon repair during that window requires modifier 24 or 25 for an E/M, or modifier 79 for an unrelated surgical procedure. An unplanned return to the OR for a complication directly related to the repair — such as tendon re-rupture at the repair site — is reported with modifier 78, not 79.

Site of service matters here. HOPD and ASC payment rates differ substantially (see the Site of Service comparison table). Most secondary profundus repairs in a healthy digit are appropriate for ASC; ensure the facility's ASC-covered procedures list includes this code before scheduling.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.2
Practice expense RVU	16.06
Malpractice RVU	1.74
Total RVU	26
Medicare national rate	$868.42
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	$868.42
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 26373 get rejected.

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

Claim submitted as primary repair (26370) vs. secondary (26373) mismatch with operative note timeline — auditors cross-check injury date.
Graft procurement documented in the operative report while billing 26373 (no-graft code); should have been 26372.
Missing laterality modifier (LT or RT) on a unilateral finger tendon repair, triggering payer edit for site specificity.
Post-op hand therapy E/M visits billed without modifier 24 during the 90-day global period, resulting in automatic bundling denial.
Multiple digits billed without sufficient documentation identifying each tendon and finger repaired separately.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 26373 from 26370 and 26372?

26370 is primary repair (at time of injury), 26372 is secondary repair using a free graft, and 26373 is secondary repair without a free graft. All three require the superficialis to be intact. The timing and graft use are the two axis points — get both right in your operative note.

02Can 26373 be billed for multiple fingers on the same day?

Yes. The descriptor specifies 'each tendon,' so a second or third digit repaired the same day is reported on a separate line. Append modifier 59 or XS to the additional units to distinguish them from the primary service and avoid automatic bundling.

03Does 26373 carry a global period, and what does that include?

26373 has a 90-day global period. The surgery day, the pre-op day-before visit, and all routine post-op care through day 90 are bundled. Unrelated E/M services need modifier 24; a staged or planned return surgery needs modifier 58; an unrelated surgical procedure needs modifier 79.

04When should modifier 78 be used with 26373?

Use modifier 78 when the patient returns to the OR during the global period for a complication directly related to the original profundus repair — for example, tendon re-rupture or wound dehiscence at the repair site. Do not use 78 for an unrelated procedure; that's modifier 79.

05Is modifier 22 ever appropriate here?

Yes, but documentation must support it. Extensive scarring from prior surgery, severe adhesions requiring significant additional dissection time, or an unusually difficult anatomical situation can justify modifier 22. The operative note must quantify the increased complexity — vague language like 'difficult case' won't hold up in audit.

06What ICD-10 diagnosis codes typically pair with 26373?

Secondary tendon repairs commonly link to late effect or subsequent encounter codes for flexor tendon injury of the finger (e.g., S66.1xx series with the appropriate seventh character), or to codes for tendon rupture or disruption (M66.3x series for spontaneous rupture). Payers will scrutinize a 'secondary' repair coded with an acute-injury primary diagnosis — the timeline must align.

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 facts that validate 26373 over its sibling codes: the injury or prior surgery date (confirming secondary timing), the intact status of the superficialis tendon, the absence of graft harvest, the specific digit and laterality, and the repair technique used. That structured capture prevents the two most common audit triggers — a primary-vs.-secondary timeline mismatch and a graft-use discrepancy — before the claim ever leaves the practice.

See how Mira captures CPT 26373 documentation