It wouldn't be hard, expense would depend on who did it.

Thanks Bryan,
I am in Massachusetts, so options are limited to the Button Box and Arthur Welch at Accordion Connection in New Hampshire, unless I want to ship it to Louisiana. If I want it to continue to sound like a Cajun accordion, how should I describe that?

If you told them Cajun tuning at 444, they should know what you mean.

Though more expensive, retune the piano accordion.

I would agree, since A440 is the current "modern" standard in US, it would be better all around to retune the Piano box. Then you can go to jams and play with others and not annoy them al the time. :)

DP