CPT code 26520: Knuckle release, metacarpophalangeal joint2026 Medicare rate & RVUs in Illinois
Surgical release of a contracted metacarpophalangeal joint to improve finger motion, reported for each knuckle joint treated.
CMS doesn’t publish an office rate for 26520 in Illinois.
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 9 sections
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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $718.35 |
| East St. Louis, IL | Unavailable | $668.55 |
| Rest of Illinois | Unavailable | $649.97 |
| Suburban Chicago, IL | Unavailable | $710.62 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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) | 0.10/0.69/0.21 | Share 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.
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%).
26520 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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