FeeBase
Log inGet started
Menu

CPT code 26520: Knuckle release, metacarpophalangeal joint2026 Medicare rate & RVUs

Surgical release of a contracted metacarpophalangeal joint to improve finger motion, reported for each knuckle joint treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.1K Medicare services in 2024

Medicare pays $670.69 for 26520 nationally in a facility.

Medicare rate · 26520

Knuckle release, metacarpophalangeal joint

Office or facility?

Work RVUs
5.33
Total RVUs
20.08
Global days
090

National rate · 2026

$670.69

Facility setting, before claim adjustments.

See every locality for 26520 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 26520 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26520 covers

This procedure releases a contracted metacarpophalangeal (MCP) joint, the knuckle where a finger meets the hand, to improve restricted motion. A hand surgeon may release the tight joint capsule or related soft tissue when contracture limits finger movement, including after injury or prolonged stiffness. The work is typically performed in an operating room or an appropriately equipped surgical setting.

Report one unit for each MCP joint released. The operative note should identify the affected digit and joint, describe the contracture and motion limitation, and document the release performed. Medicare assigns 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 26520 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

26520 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$598.58
AlaskaUnavailable$774.22
ArizonaUnavailable$651.57
ArkansasUnavailable$589.50
Atlanta, GAUnavailable$685.41
Austin, TXUnavailable$693.76
Bakersfield, CAUnavailable$704.78
Baltimore area, MDUnavailable$715.09
Beaumont, TXUnavailable$627.00
Brazoria, TXUnavailable$660.49

26520 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
26520 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 26520 rate is calculated

Each of 26520’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 · 26520

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.33

5.33 RVUs× 1.000 GPCI

Practice expense13.73

13.73 RVUs× 1.000 GPCI

Malpractice1.02

1.02 RVUs× 1.000 GPCI

Adjusted RVUs

20.0800

Conversion factor

$33.4009

Medicare rate

$670.69

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26520

26520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26520

Knuckle release, metacarpophalangeal joint

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26520

Knuckle release, metacarpophalangeal joint

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

26520 without 51 · national facility

$670.69

Knuckle release, metacarpophalangeal joint

26520-51 · Second procedure: 50%

$335.35

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

26520 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26520

    Knuckle release, metacarpophalangeal joint5.33 wRVU

    Not priced

  • 26525

    Contracture release, finger interphalangeal joint5.36 wRVU

    Not priced

  • 26508

    Thumb contracture release, thumb soft-tissue contracture6.03 wRVU

    Not priced

  • 26530

    Knuckle arthroplasty, metacarpophalangeal joint, no implant6.71 wRVU

    Not priced

How to choose

26525Contracture releaseFinger interphalangeal joint
Choose 26520 for release at the MCP knuckle. Choose 26525 when the contracted joint is an interphalangeal joint within a finger.
26508Thumb contracture releaseThumb soft-tissue contracture
This code addresses an MCP joint in a finger; 26508 is specific to contracture release involving the thumb.
26530Knuckle arthroplastyMetacarpophalangeal joint, no implant
26520 releases a contracted MCP joint. Code 26530 describes revision of the MCP joint rather than release of its contracture.

Codes related to 26520

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

Codes related to 26520
CodeHow it relatesNational office range
Same family
26525Contracture release, finger interphalangeal jointReleases a finger interphalangeal joint contracture rather than an MCP joint contracture.No office rate
Used instead
26508Thumb contracture release, thumb soft-tissue contractureA thumb-specific contracture release when the contracted joint is in the thumb.No office rate
26516Knuckle fusion, metacarpophalangeal jointMCP joint fusion may be selected when the operative plan is to fuse the knuckle joint.No office rate

26520 billing questions

When should this code be chosen instead of 26525?

Use 26520 for release of a contracted MCP knuckle joint. Code 26525 is for a contracture release at a finger interphalangeal joint.

How many units should be reported?

Report one unit for each MCP joint released. The operative documentation should identify each treated joint.

Can modifier 50 be used when both hands are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Document the joints treated rather than applying modifier 50.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

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
RVUs for 26520PPRRVU2026_Oct_nonQPP.csv, line 2,628 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26520 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 26520 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist