CPT code 26517: Knuckle fusion, metacarpophalangeal joint2026 Medicare rate & RVUs

Medicare pays $845.38 for 26517 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 26517 covers

A hand surgeon surgically fuses a metacarpophalangeal (MCP) joint, the knuckle where a finger meets the hand, to create a stable joint by eliminating motion there. The procedure may be considered for severe joint disease, deformity, or instability when preserving motion is not the goal. It is performed in an operating room, commonly in a hospital or ambulatory surgery center. The operative report should identify the finger and MCP joint treated and describe the fusion performed.

Report this code for the MCP fusion work documented in the operative note; distinguish it from procedures on the finger’s interphalangeal joints and from joint reconstruction or contracture release. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures reported with modifier 50, CMS pays 150%. An assistant at surgery may be paid; 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 26517 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

26517 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 26517 rate is calculated

Each of 26517’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.

Payment rules and modifiers for 26517

26517 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

26517 compared with similar codes

How to choose

26516Knuckle fusionMetacarpophalangeal joint

Both are in the MCP fusion group. Use the full CPT descriptor and operative details to distinguish the code-level service; the CMS short label alone does not supply that distinction.

26518Knuckle fusionMultiple joints

This is another code in the MCP fusion group. Confirm the full descriptor against the documented procedure rather than choosing between the codes from the abbreviated CMS labels.

26520Knuckle releaseMetacarpophalangeal joint

26520 is for release of an MCP contracture. Choose the fusion code when the surgeon fuses the knuckle joint, not when the documented service is contracture release.

26530Knuckle arthroplastyMetacarpophalangeal joint, no implant

26530 describes MCP joint revision, while this code represents fusion. The operative procedure determines which service was performed.

Codes related to 26517

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates