CPT code 26341: Cord manipulation, after enzyme injection2026 Medicare rate & RVUs
Reports manipulation of a Dupuytren palmar cord after enzyme injection to improve contracture in a treated finger.
Medicare pays $124.25 for 26341 nationally in the office and $73.15 in a hospital or facility. Local office rates run $108.97–$164.16.
Medicare rate · 26341
Cord manipulation, after enzyme injection
- Work RVUs
- 0.89
- Total RVUs
- 3.72
- Global days
- 010
National rate · 2026
$124.25
Office setting, before claim adjustments.
See every locality for 26341 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 26341 covers
A hand surgeon or other qualified physician manipulates the treated finger and palmar tissue to disrupt a Dupuytren cord after an enzyme injection, such as collagenase. The service is directed at the contracture caused by the injected cord, rather than a stiff finger joint unrelated to enzyme treatment. It is commonly performed in an office or other procedural setting as the follow-up treatment to the injection.
Report this code for one treated digit in a hand; manipulation may address multiple cords in that hand. Documentation should identify the treated hand and digit, the prior enzyme injection, and the manipulation performed. The related postoperative visits are included for 10 days. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 26341 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$108.97 to $164.16
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $110.68 | $65.97 |
| Alaska | $142.34 | $87.92 |
| Arizona | $120.68 | $71.16 |
| Arkansas | $108.97 | $65.07 |
| Atlanta, GA | $126.90 | $74.98 |
| Austin, TX | $128.82 | $74.75 |
| Bakersfield, CA | $131.13 | $75.12 |
| Baltimore area, MD | $132.56 | $77.72 |
| Beaumont, TX | $115.85 | $69.35 |
| Brazoria, TX | $122.44 | $71.80 |
| Chicago, IL | $132.26 | $80.90 |
| Chico, CA | $130.65 | $74.64 |
| Colorado | $129.05 | $74.68 |
| Connecticut | $132.88 | $77.84 |
| Dallas, TX | $123.36 | $72.46 |
| Delaware | $122.76 | $72.27 |
| Detroit, MI | $125.04 | $75.72 |
| East St. Louis, IL | $122.90 | $75.89 |
| El Centro, CA | $130.68 | $74.67 |
| Fort Lauderdale, FL | $129.99 | $78.23 |
| Fort Worth, TX | $122.54 | $72.15 |
| Fresno, CA | $130.65 | $74.64 |
| Galveston, TX | $122.89 | $72.14 |
| Hanford, CA | $130.65 | $74.64 |
| Hawaii, Guam, HI | $134.03 | $75.93 |
| Houston, TX | $126.00 | $75.26 |
| Idaho | $114.15 | $67.14 |
| Indiana | $114.85 | $67.47 |
| Iowa | $113.28 | $66.52 |
| Kansas | $112.91 | $66.71 |
| Kentucky | $113.91 | $68.48 |
| King County, WA | $144.87 | $82.16 |
| Los Angeles, CA | $139.82 | $79.37 |
| Madera, CA | $130.65 | $74.64 |
| Manhattan, NY | $143.87 | $84.49 |
| Marin County, CA | $160.43 | $88.37 |
| Merced, CA | $130.65 | $74.64 |
| Metropolitan Boston, MA | $142.08 | $81.06 |
| Metropolitan Kansas City, MO | $118.70 | $70.72 |
| Metropolitan Philadelphia, PA | $129.53 | $76.33 |
| Metropolitan St. Louis, MO | $120.00 | $71.35 |
| Miami, FL | $136.58 | $83.38 |
| Minnesota | $122.83 | $70.25 |
| Mississippi | $110.42 | $66.42 |
| Modesto, CA | $130.65 | $74.64 |
| Montana | $124.24 | $73.14 |
| Napa, CA | $151.58 | $84.23 |
| Nebraska | $113.88 | $66.71 |
| Nevada | $123.39 | $72.24 |
| New Hampshire | $127.18 | $73.99 |
| New Mexico | $118.02 | $71.16 |
| New Orleans, LA | $119.78 | $71.69 |
| North Carolina | $116.25 | $68.57 |
| North Dakota | $120.88 | $69.78 |
| Northern New Jersey | $140.73 | $81.45 |
| NYC suburbs and Long Island, NY | $147.81 | $87.05 |
| Ohio | $116.57 | $69.91 |
| Oklahoma | $113.48 | $67.84 |
| Oxnard, CA | $139.11 | $78.71 |
| Portland, OR | $133.14 | $76.36 |
| Poughkeepsie and northern NYC suburbs, NY | $135.22 | $79.26 |
| Puerto Rico | $125.14 | $73.48 |
| Queens, NY | $144.83 | $84.43 |
| Redding, CA | $130.65 | $74.64 |
| Rest of California | $130.65 | $74.64 |
| Rest of Florida | $123.20 | $74.34 |
| Rest of Georgia | $115.75 | $70.16 |
| Rest of Illinois | $119.72 | $73.06 |
| Rest of Louisiana | $113.80 | $68.57 |
| Rest of Maine | $115.00 | $67.98 |
| Rest of Maryland | $125.15 | $73.43 |
| Rest of Massachusetts | $128.28 | $74.47 |
| Rest of Michigan | $117.25 | $70.60 |
| Rest of Missouri | $111.84 | $67.79 |
| Rest of New Jersey | $134.17 | $78.36 |
| Rest of New York | $118.12 | $69.57 |
| Rest of Oregon | $122.21 | $71.31 |
| Rest of Pennsylvania | $116.65 | $69.74 |
| Rest of Texas | $119.17 | $70.67 |
| Rest of Washington | $127.99 | $74.18 |
| Rhode Island | $127.13 | $74.35 |
| Riverside, CA | $132.48 | $76.47 |
| Sacramento, CA | $137.17 | $77.74 |
| Salinas, CA | $136.66 | $77.44 |
| San Benito County, CA | $164.16 | $90.47 |
| San Diego, CA | $139.96 | $78.84 |
| San Francisco, CA | $160.24 | $88.18 |
| San Luis Obispo, CA | $134.47 | $76.26 |
| Santa Clara County, CA | $163.37 | $89.68 |
| Santa Cruz, CA | $141.34 | $79.25 |
| Santa Maria, CA | $137.20 | $77.61 |
| Santa Rosa, CA | $142.77 | $80.01 |
| South Carolina | $116.65 | $69.43 |
| South Dakota | $120.48 | $69.38 |
| Southern Maine, ME | $121.36 | $70.71 |
| Stockton, CA | $130.65 | $74.64 |
| Suburban Chicago, IL | $131.24 | $78.76 |
| Tennessee | $113.54 | $67.08 |
| Utah | $118.34 | $70.30 |
| Vallejo, CA | $151.31 | $83.95 |
| Vermont | $120.56 | $69.97 |
| Virgin Islands, VI | $125.14 | $73.48 |
| Virginia | $121.07 | $70.84 |
| Visalia, CA | $130.65 | $74.64 |
| Washington, DC area | $142.31 | $82.11 |
| West Virginia | $115.06 | $70.65 |
| Wisconsin | $116.59 | $67.63 |
| Wyoming | $122.78 | $71.67 |
| Yuba City, CA | $130.65 | $74.64 |
26341 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$108.97
$147.41
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $142.34 | 1 |
| AL | $110.68 | 1 |
| AR | $108.97 | 1 |
| AZ | $120.68 | 1 |
| CA | $130.65–$164.16 | 29 |
| CO | $129.05 | 1 |
| CT | $132.88 | 1 |
| DC | $142.31 | 1 |
| DE | $122.76 | 1 |
| FL | $123.20–$136.58 | 3 |
| GA | $115.75–$126.90 | 2 |
| GU | $134.03 | 1 |
| HI | $134.03 | 1 |
| IA | $113.28 | 1 |
| ID | $114.15 | 1 |
| IL | $119.72–$132.26 | 4 |
| IN | $114.85 | 1 |
| KS | $112.91 | 1 |
| KY | $113.91 | 1 |
| LA | $113.80–$119.78 | 2 |
| MA | $128.28–$142.08 | 2 |
| MD | $125.15–$142.31 | 3 |
| ME | $115.00–$121.36 | 2 |
| MI | $117.25–$125.04 | 2 |
| MN | $122.83 | 1 |
| MO | $111.84–$120.00 | 3 |
| MS | $110.42 | 1 |
| MT | $124.24 | 1 |
| NC | $116.25 | 1 |
| ND | $120.88 | 1 |
| NE | $113.88 | 1 |
| NH | $127.18 | 1 |
| NJ | $134.17–$140.73 | 2 |
| NM | $118.02 | 1 |
| NV | $123.39 | 1 |
| NY | $118.12–$147.81 | 5 |
| OH | $116.57 | 1 |
| OK | $113.48 | 1 |
| OR | $122.21–$133.14 | 2 |
| PA | $116.65–$129.53 | 2 |
| PR | $125.14 | 1 |
| RI | $127.13 | 1 |
| SC | $116.65 | 1 |
| SD | $120.48 | 1 |
| TN | $113.54 | 1 |
| TX | $115.85–$128.82 | 8 |
| UT | $118.34 | 1 |
| VA | $121.07–$142.31 | 2 |
| VI | $125.14 | 1 |
| VT | $120.56 | 1 |
| WA | $127.99–$144.87 | 2 |
| WI | $116.59 | 1 |
| WV | $115.06 | 1 |
| WY | $122.78 | 1 |
How the 26341 rate is calculated
Each of 26341’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 26341
RVUs × geographic indexes × conversion factor
Work0.89
0.89 RVUs× 1.000 GPCI
Practice expense2.66
2.66 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
3.7200
Conversion factor
$33.4009
Medicare rate
$124.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26341
26341 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26341
Cord manipulation, after enzyme injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26341
Cord manipulation, after enzyme injection
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
26341 without 50 · national office
$124.25
Cord manipulation, after enzyme injection
26341-50 · Bilateral: 150%
$186.38
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
26341 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20527Palmar cord injectionEnzyme injection
- 20527 represents injection of an enzyme into a Dupuytren cord. Code 26341 represents the later manipulation of the treated cord.
- 26340Finger manipulationUnder anesthesia, each joint
- 26340 applies to manipulation of a finger joint under anesthesia. Choose 26341 when the target is a palmar cord after enzyme injection.
- 26123Dupuytren releasePalm and one digit
- 26123 describes surgical removal or release of palmar fascia for Dupuytren contracture; 26341 describes manipulation after enzyme treatment.
26341 billing questions
How does this differ from 26340?
Use 26341 for manipulation of a palmar Dupuytren cord after enzyme injection. Code 26340 describes manipulation of a finger joint under anesthesia, not post-injection cord disruption.
Is the enzyme injection included?
No. Code 26341 represents the subsequent manipulation; report the injection separately with 20527 when performed and otherwise reportable.
What documentation supports the code?
Document the enzyme-treated Dupuytren cord, the hand and digit treated, and the manipulation performed. Identify multiple cords if they were addressed in the same hand.
How is bilateral treatment handled?
For treatment of both hands, CMS pays modifier 50 at 150%. The service is described per hand, for a single digit, including multiple cords.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50%. Related postoperative visits are included during the 10-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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