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CPT code 26531: Knuckle arthroplasty, with implant2026 Medicare rate & RVUs

Reports implant arthroplasty of a metacarpophalangeal joint to address painful joint destruction or deformity while preserving finger motion.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.5K Medicare services in 2024

Medicare pays $588.19 for 26531 nationally in a facility.

Medicare rate · 26531

Knuckle arthroplasty, with implant

Office or facility?

Work RVUs
7.93
Total RVUs
17.61
Global days
090

National rate · 2026

$588.19

Facility setting, before claim adjustments.

See every locality for 26531 →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 26531 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 26531 covers

A hand surgeon removes damaged joint surfaces at a metacarpophalangeal (MCP) joint and places an implant to improve alignment and preserve motion. Typical cases include painful MCP destruction and deformity from rheumatoid arthritis, or joint damage from other causes. The procedure is generally performed in an operating room, with the specific finger and joint identified in the operative report.

Report this code when the operation includes an implant at the MCP joint; distinguish it from MCP arthroplasty without an implant and implant arthroplasty at a finger interphalangeal joint. Documentation should establish the treated joint, the underlying problem, and implant placement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 26531 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

26531 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$532.40
AlaskaUnavailable$716.06
ArizonaUnavailable$572.54
ArkansasUnavailable$525.48
Atlanta, GAUnavailable$603.36
Austin, TXUnavailable$598.91
Bakersfield, CAUnavailable$600.02
Baltimore area, MDUnavailable$624.19
Beaumont, TXUnavailable$560.04
Brazoria, TXUnavailable$576.90

26531 rates by state

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

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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
26531 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 26531 rate is calculated

Each of 26531’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 · 26531

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.93

7.93 RVUs× 1.000 GPCI

Practice expense8.19

8.19 RVUs× 1.000 GPCI

Malpractice1.49

1.49 RVUs× 1.000 GPCI

Adjusted RVUs

17.6100

Conversion factor

$33.4009

Medicare rate

$588.19

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

Payment rules and modifiers for 26531

26531 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26531

Knuckle arthroplasty, with implant

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 26531

Knuckle arthroplasty, with implant

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

26531 without 51 · national facility

$588.19

Knuckle arthroplasty, with implant

26531-51 · Second procedure: 50%

$294.10

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

26531 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26531

    Knuckle arthroplasty, with implant7.93 wRVU

    Not priced

  • 26530

    Knuckle arthroplasty, metacarpophalangeal joint, no implant6.71 wRVU

    Not priced

  • 26536

    Finger joint arthroplasty, with prosthetic implant6.4 wRVU

    Not priced

  • 26516

    Knuckle fusion, metacarpophalangeal joint7.14 wRVU

    Not priced

How to choose

26530Knuckle arthroplastyMetacarpophalangeal joint, no implant
Both address MCP joint arthroplasty, but 26531 includes implant placement; 26530 is for arthroplasty without an implant.
26536Finger joint arthroplastyWith prosthetic implant
Both involve implant arthroplasty, but 26536 is for a finger interphalangeal joint. Use 26531 for an MCP joint.
26516Knuckle fusionMetacarpophalangeal joint
This code describes fusion of an MCP joint. Choose it when the operation fuses the joint, not when an implant arthroplasty is performed.

Codes related to 26531

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

Codes related to 26531
CodeHow it relatesNational office range
Same family
26530Knuckle arthroplasty, metacarpophalangeal joint, no implantMCP arthroplasty without an implant.No office rate
Used instead
26536Finger joint arthroplasty, with prosthetic implantImplant arthroplasty for an interphalangeal joint rather than an MCP joint.No office rate
26516Knuckle fusion, metacarpophalangeal jointMCP joint fusion, which sacrifices joint motion rather than replacing the joint with an implant.No office rate

26531 billing questions

How does this differ from 26530?

Use 26531 when an implant is placed during MCP joint arthroplasty. Code 26530 describes MCP arthroplasty without an implant.

Can this code be used for an implant at a finger joint?

No. This code is for a metacarpophalangeal joint. Code 26536 describes implant arthroplasty at an interphalangeal joint.

Should modifier 50 be reported when both hands are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Follow the applicable reporting instructions for the procedures performed on each hand.

What postoperative care is included?

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

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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 26531PPRRVU2026_Oct_nonQPP.csv, line 2,631 (RVU26D)

Open CMS sourceHow we calculate rates

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