Transfer or transplant of a tendon in the carpometacarpal area or dorsum of the hand using a free tendon graft, including harvest of the graft; reported per tendon.

Verified May 8, 2026 · 6 sources ↓

Medicare: $835.02
Total RVUs: 25
Global, days: 90
Region: Hand

Drawn from CMSAAPCGenhealthBedrockbillingAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the exact tendon(s) transferred or transplanted by name (e.g., FCR, palmaris longus, extensor indicis proprius) and anatomical location (CMC area vs. dorsum of hand).
Document the donor site and graft harvest technique — the code includes obtaining the graft, so the operative note must confirm graft harvest was performed by the same surgeon.
Record the indication clearly: injury, degenerative disease, congenital condition, or prior failed repair — payers require medical necessity tied to functional deficit.
If billing multiple units of 26483, the operative note must identify each tendon separately with distinct procedural descriptions supporting separate reporting.
Document the approach and any adjunct procedures (e.g., arthroplasty, implant placement) with enough detail to defend separate billing against NCCI bundling challenges.
If modifier 22 is appended, include a brief narrative in the claim explaining the substantially increased work — scarring, prior surgery, anatomic anomaly, or prolonged operative time.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 26483 covers tendon transfer or transplant procedures in the carpometacarpal region or dorsal hand where a free tendon graft is used — and the code includes harvesting that graft. It is reported per tendon, so each additional tendon requires a separate unit with modifier 59 to establish distinct procedural identity. The carpometacarpal area encompasses the articulation between the wrist's carpal bones and the proximal bases of the five metacarpals, a zone frequently involved in post-traumatic reconstruction, ligament arthroplasty (e.g., LRTI for thumb CMC arthritis), and opponensplasty.

This code carries a 90-day global period. Any related return to the OR within that window needs modifier 78; an unrelated procedure needs modifier 79. An E/M on the day before or day of surgery — if that visit was when the decision for surgery was made — requires modifier 57 appended to the E/M code, not to 26483. Staged reconstructions planned at the time of initial surgery use modifier 58, which resets the global clock.

Billing 26483 alongside arthroplasty codes (e.g., 25447 for CMC interposition) is common in LRTI procedures, but NCCI edits and payer-specific bundling rules govern which combinations survive audit. Check NCCI column pairs before submitting — several adjacent tendon and arthroplasty codes have bundling relationships with 26483 that require modifier 59 or XS to unbundle when clinically distinct.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.27
Practice expense RVU	15.16
Malpractice RVU	1.57
Total RVU	25
Medicare national rate	$835.02
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	$835.02
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 26483 get rejected.

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

Bundling denial when 26483 is billed same-day with arthroplasty or adjacent tendon codes without modifier 59 or XS establishing distinct procedural service.
Medical necessity denial due to vague or absent diagnosis linking functional deficit to the specific tendon reconstructed.
Multiple units denied when the operative note does not individually identify and describe each tendon, making the per-tendon units unverifiable.
Global period conflict when a related post-op procedure is submitted without modifier 78, or an unrelated one without modifier 79.
Bilateral denial when LT/RT laterality modifiers are omitted or when modifier 50 is used without confirming payer accepts bilateral billing format for this code.

Frequently asked questions

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

01How does 26483 differ from 26480?

26480 covers tendon transfer in the same anatomical zone (CMC area or dorsum of hand) without a free graft — the tendon is rerouted, not supplemented with harvested tissue. Use 26483 when a free tendon graft is obtained and used. ASSH coding guidance specifically directs 26480 for tendon transfer into the CMC area in LRTI when no free graft is used.

02Can 26483 be billed with 25447 for an LRTI procedure?

It depends on what was actually done. Some LRTI constructs involve a free graft harvest that supports a 26483 charge alongside 25447; others do not. NCCI edits and individual payer policies govern this pairing — verify column pair status before submitting, and use modifier 59 or XS if the procedures are clinically distinct and separately documented.

03Is each tendon a separate unit of 26483?

Yes. The code is defined per tendon. Each additional tendon transferred or transplanted with a free graft in the same session is billed as a separate unit of 26483. The operative note must individually describe each tendon to support multiple units — a single narrative covering all tendons collectively will not survive audit.

04What modifier applies if the patient returns to the OR for a wound complication within the 90-day global?

Modifier 78 applies when the return to the OR is for a procedure related to the original surgery — including complications. Modifier 79 is for an unrelated procedure by the same surgeon during the global period. Do not invert these. A wound dehiscence requiring OR-level irrigation and closure is a modifier 78 scenario, not 79.

05Does the 90-day global period affect E/M billing for hand therapy follow-up?

Routine post-op visits are bundled into the 90-day global — they are not separately billable. E/M services for a new or unrelated problem during the global period require modifier 24. If the E/M documents a significant, separately identifiable service on the same day as a minor procedure, modifier 25 applies to the E/M.

06When is modifier 22 justified for 26483?

Modifier 22 is appropriate when operative complexity substantially exceeds the typical case — examples include heavily scarred fields from prior surgery, anatomic anomalies requiring significant graft modification, or markedly prolonged operative time. The claim must be accompanied by a written justification; simply appending 22 without documentation support invites audit and recoupment.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures tendon name, donor site, graft harvest confirmation, and anatomical zone (CMC vs. dorsal hand) directly from dictation. For multi-tendon cases, it flags each tendon as a discrete unit. That specificity prevents the most common denial: a claim for multiple 26483 units unsupported by per-tendon documentation in the operative note.

See how Mira captures CPT 26483 documentation