Surgical shortening of a flexor tendon in the hand or finger — one tendon per reporting unit — to correct an elongated tendon causing joint instability.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $676.03
- Work RVU
- 5.76
- Global, days
- 90
- Region
- Hand
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Identify the specific tendon by name and the digit involved (e.g., FDP of the long finger)
- Describe the clinical indication — joint instability, laxity, or functional impairment caused by tendon elongation
- Operative note must specify the surgical technique: length of tendon segment resected and method of reapproximation
- Confirm the procedure is shortening (resection), not lengthening — auditors cross-check the operative description against the billed code
- If billing multiple units for multiple tendons same-day, enumerate each tendon and digit separately in the operative note
- Document pre-op imaging or clinical exam findings supporting the diagnosis of tendon elongation
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 5 cited references ↓
CPT 26479 covers the surgical shortening of a single flexor tendon in the hand or finger. The procedure addresses an elongated tendon — typically due to prior injury, failed repair, or degenerative change — that results in a lax, unstable joint. The surgeon resects a measured segment of the tendon and reapproximates the ends to restore appropriate tension and joint mechanics. Code this once per tendon; multiple tendons on the same hand require separate units with supporting documentation identifying each tendon by name and digit.
This code carries a 90-day global period. Routine post-op visits, splint or cast changes, and dressing management through day 90 are included. Unrelated E/M services in the global window need modifier 24; a separate procedure for a distinct condition needs modifier 79. Complications requiring a return to the OR for the same tendon fall under modifier 78.
Don't confuse 26479 (shortening) with 26478 (lengthening, same anatomic region). The two are not interchangeable, and payers will deny if the operative note describes lengthening but the claim bills shortening, or vice versa. Document the direction of modification explicitly.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (5.76) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.24) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 5.76 |
| Practice expense RVU | 13.25 |
| Malpractice RVU | 1.23 |
| Total RVU | 20.24 |
| Medicare national rate | $676.03 |
| 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 | $676.03 |
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 26479 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Operative note describes tendon lengthening but 26479 (shortening) is billed — use 26478 for lengthening
- Unbundling denial when multiple tendons on the same hand are billed without individual tendon-level documentation
- Routine post-op visits billed separately during the 90-day global period without modifier 24 or 79
- Lack of documented clinical indication connecting joint instability or functional deficit to the elongated tendon
- Units of service exceed MUE without distinct tendon identification in the operative note
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01Can I bill 26479 more than once if I shorten two tendons in the same hand during the same session?
02What's the difference between 26478 and 26479?
03Does the 90-day global period affect how I bill follow-up visits after this surgery?
04If the patient returns to the OR within 90 days because the shortened tendon repair fails, which modifier applies?
05Is modifier 51 appropriate when 26479 is billed alongside another hand procedure on the same day?
06What ICD-10 diagnosis codes support medical necessity for 26479?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira Scribe
Mira's AI scribe captures the tendon name, digit, resected segment length, and reapproximation technique directly from the operative dictation, then flags if the note uses language consistent with lengthening rather than shortening. This prevents the single most common denial for 26479: a mismatch between the operative description and the billed code direction.
See how Mira captures CPT 26479 documentation