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CPT code 26536: Finger joint arthroplasty, with prosthetic implant2026 Medicare rate & RVUs

Reports arthroplasty of a finger interphalangeal joint using a prosthetic implant, typically to address painful joint damage or deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.3K Medicare services in 2024

Medicare pays $731.15 for 26536 nationally in a facility.

Medicare rate · 26536

Finger joint arthroplasty, with prosthetic implant

Office or facility?

Work RVUs
6.4
Total RVUs
21.89
Global days
090

National rate · 2026

$731.15

Facility setting, before claim adjustments.

See every locality for 26536 →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 26536 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 26536 covers

This procedure replaces or reconstructs the surfaces of a finger interphalangeal joint with a prosthetic implant. Hand surgeons, including orthopedic or plastic surgeons with hand expertise, may perform it for painful joint destruction, stiffness, or deformity, such as from arthritis or prior injury. The treated joint may be proximal or distal; the operative report should identify the joint and document the implant placement.

Choose this code when the interphalangeal joint arthroplasty includes a prosthetic implant, rather than the nonimplant procedure reported with 26535. Report it per treated joint, supported by the operative details; CMS does not apply the bilateral adjustment, so modifier 50 is inappropriate. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, CMS pays the highest-valued procedure in full and other procedures at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 26536 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

26536 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$653.88
AlaskaUnavailable$850.71
ArizonaUnavailable$710.50
ArkansasUnavailable$644.18
Atlanta, GAUnavailable$747.60
Austin, TXUnavailable$754.57
Bakersfield, CAUnavailable$765.03
Baltimore area, MDUnavailable$779.02
Beaumont, TXUnavailable$685.36
Brazoria, TXUnavailable$719.60

26536 rates by state

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

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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
26536 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 26536 rate is calculated

Each of 26536’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 · 26536

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.40

6.40 RVUs× 1.000 GPCI

Practice expense14.27

14.27 RVUs× 1.000 GPCI

Malpractice1.22

1.22 RVUs× 1.000 GPCI

Adjusted RVUs

21.8900

Conversion factor

$33.4009

Medicare rate

$731.15

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

Payment rules and modifiers for 26536

26536 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26536

Finger joint arthroplasty, with prosthetic 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)0Not paid without supporting documentation.
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 · 26536

Finger joint arthroplasty, with prosthetic 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

26536 without 51 · national facility

$731.15

Finger joint arthroplasty, with prosthetic implant

26536-51 · Second procedure: 50%

$365.58

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

26536 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26536

    Finger joint arthroplasty, with prosthetic implant6.4 wRVU

    Not priced

  • 26535

    Finger joint surgery, without prosthetic implant5.27 wRVU

    Not priced

  • 26530

    Knuckle arthroplasty, metacarpophalangeal joint, no implant6.71 wRVU

    Not priced

  • 26531

    Knuckle arthroplasty, with implant7.93 wRVU

    Not priced

How to choose

26535Finger joint surgeryWithout prosthetic implant
Both codes describe interphalangeal joint arthroplasty. Choose 26536 when the procedure includes a prosthetic implant; 26535 is for arthroplasty without one.
26530Knuckle arthroplastyMetacarpophalangeal joint, no implant
This code concerns metacarpophalangeal joint arthroplasty, not an interphalangeal joint. Select based on the joint actually treated.
26531Knuckle arthroplastyWith implant
This code describes implant arthroplasty at a metacarpophalangeal joint. Code 26536 is for implant arthroplasty at a finger interphalangeal joint.

Codes related to 26536

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

Codes related to 26536
CodeHow it relatesNational office range
Same family
26535Finger joint surgery, without prosthetic implantInterphalangeal joint arthroplasty without a prosthetic implant.No office rate
Used instead
26530Knuckle arthroplasty, metacarpophalangeal joint, no implantArthroplasty of a metacarpophalangeal joint rather than an interphalangeal joint.No office rate
26531Knuckle arthroplasty, with implantMetacarpophalangeal joint arthroplasty with an implant; the joint site differs.No office rate

26536 billing questions

When should 26536 be chosen over 26535?

Use 26536 when a prosthetic implant is placed during interphalangeal joint arthroplasty. Use 26535 when the arthroplasty is performed without a prosthetic implant.

Is the implant separately reported?

The implant placement is part of this arthroplasty service. The operative report should establish that a prosthetic implant was used.

How are multiple treated finger joints reported?

This code is reported per treated interphalangeal joint. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate.

What postoperative care is included?

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

Can an assistant surgeon or co-surgeon be paid?

Assistant-at-surgery payment requires documentation of medical necessity. 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 26536PPRRVU2026_Oct_nonQPP.csv, line 2,633 (RVU26D)

Open CMS sourceHow we calculate rates

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