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CPT code 26540: Ligament repair, MCP or IP joint2026 Medicare rate & RVUs

Reports operative repair of a collateral ligament at a finger or thumb MCP or IP joint, such as repair of an injured thumb MCP ligament.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.2K Medicare services in 2024

Medicare pays $679.37 for 26540 nationally in a facility.

Medicare rate · 26540

Ligament repair, MCP or IP joint

Office or facility?

Work RVUs
6.44
Total RVUs
20.34
Global days
090

National rate · 2026

$679.37

Facility setting, before claim adjustments.

See every locality for 26540 →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 26540 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 26540 covers

This surgery repairs a collateral ligament that stabilizes a metacarpophalangeal (MCP) or interphalangeal (IP) joint in the hand. A typical example is direct repair of a torn thumb MCP collateral ligament after an injury; the service may also involve another finger joint. An orthopedic or hand surgeon performs the operation, usually in an operating room, using the operative approach and repair technique appropriate to the ligament injury.

Report the code when the surgeon repairs the joint’s collateral ligament without the graft-based work represented by related codes. The operative report should identify the joint and side, describe the ligament injury, and document the repair performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur 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. Assistant-at-surgery and co-surgeon payment require supporting documentation; 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 26540 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

26540 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$608.54
AlaskaUnavailable$795.81
ArizonaUnavailable$660.30
ArkansasUnavailable$599.66
Atlanta, GAUnavailable$695.11
Austin, TXUnavailable$699.61
Bakersfield, CAUnavailable$707.86
Baltimore area, MDUnavailable$723.50
Beaumont, TXUnavailable$638.38
Brazoria, TXUnavailable$668.18

26540 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
26540 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 26540 rate is calculated

Each of 26540’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 · 26540

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.44

6.44 RVUs× 1.000 GPCI

Practice expense12.66

12.66 RVUs× 1.000 GPCI

Malpractice1.24

1.24 RVUs× 1.000 GPCI

Adjusted RVUs

20.3400

Conversion factor

$33.4009

Medicare rate

$679.37

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

Payment rules and modifiers for 26540

26540 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26540

Ligament repair, MCP or IP 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)0Not paid without supporting documentation.
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 · 26540

Ligament repair, MCP or IP 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

26540 without 51 · national facility

$679.37

Ligament repair, MCP or IP joint

26540-51 · Second procedure: 50%

$339.69

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

26540 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26540

    Ligament repair, MCP or IP joint6.44 wRVU

    Not priced

  • 26541

    Ligament repair, with tendon graft8.59 wRVU

    Not priced

  • 26542

    Joint ligament repair, with tendon graft6.78 wRVU

    Not priced

  • 26545

    Finger joint reconstruction, ligament reconstruction with graft6.93 wRVU

    Not priced

How to choose

26541Ligament repairWith tendon graft
26540 describes collateral-ligament repair without graft-based work. Choose 26541 when the documented procedure includes the graft-based repair represented by that code.
26542Joint ligament repairWith tendon graft
This is a related graft-based hand-joint repair code. Distinguish it from 26540 by the graft work documented in the operative report.
26545Finger joint reconstructionLigament reconstruction with graft
26545 describes finger-joint reconstruction, rather than the collateral-ligament repair represented by 26540. Select based on the procedure actually performed.

Codes related to 26540

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

Codes related to 26540
CodeHow it relatesNational office range
Same family
26541Ligament repair, with tendon graftRelated collateral-ligament repair code involving graft-based work.No office rate
26542Joint ligament repair, with tendon graftGraft-based hand-joint repair option in the same surgical family.No office rate
Used instead
26545Finger joint reconstruction, ligament reconstruction with graftA finger-joint reconstruction may be selected when the operation is reconstructive rather than direct repair.No office rate

26540 billing questions

When should 26540 be chosen over a graft-based repair code?

Use 26540 for repair of the collateral ligament without the graft-based work described by 26541 or 26542. The operative report should support the technique actually performed.

Can this code be reported for a thumb MCP ligament repair?

Yes. Direct repair of an injured thumb MCP collateral ligament is a typical example; document the joint, side, injury, and repair.

Should modifier 50 be used for repairs on both hands?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What postoperative care is included?

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

When is an assistant surgeon payable?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeon payment also requires supporting documentation.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.

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 26540PPRRVU2026_Oct_nonQPP.csv, line 2,634 (RVU26D)

Open CMS sourceHow we calculate rates

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