CPT code 26545: Finger joint reconstruction, ligament reconstruction with graft2026 Medicare rate & RVUs in Missouri
Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability.
CMS doesn’t publish an office rate for 26545 in Missouri.
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
On this page 9 sections
What 26545 covers
The surgeon reconstructs a stabilizing ligament at a finger joint using graft tissue when the existing ligament is deficient or unsuitable for a straightforward repair. This may be considered for persistent instability after an injury, including cases in which damaged ligament tissue cannot hold a direct repair. A hand or orthopedic surgeon typically performs the procedure in an operating room, with the operative report identifying the joint, the ligament addressed, and the graft used or obtained.
Report this service when the operative work supports ligament reconstruction with graft, rather than direct ligament repair or a joint replacement or fusion. Documentation should describe the instability or ligament deficiency, the reconstruction performed, and the graft. CMS classifies the procedure as major surgery with 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 others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of 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 26545 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $680.06 |
| Metropolitan St. Louis, MO | Unavailable | $686.77 |
| Rest of Missouri | Unavailable | $646.65 |
How the 26545 rate is calculated
Each of 26545’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 · 26545
RVUs × geographic indexes × conversion factor
Work6.93
6.93 RVUs× 1.000 GPCI
Practice expense12.94
12.94 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
21.1800
Conversion factor
$33.4009
Medicare rate
$707.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26545
26545 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26545
Finger joint reconstruction, ligament reconstruction with graft
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 26545
Finger joint reconstruction, ligament reconstruction with graft
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
26545 without 51 · national facility
$707.43
Finger joint reconstruction, ligament reconstruction with graft
26545-51 · Second procedure: 50%
$353.72
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%).
26545 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26540Ligament repairMCP or IP joint
- 26540 describes direct collateral ligament repair. Report 26545 when the surgeon reconstructs the ligament using graft tissue.
- 26541Ligament repairWith tendon graft
- 26541 is a ligament repair involving a tendon graft; distinguish it from the reconstruction performed for this code by the operative technique documented.
- 26530Knuckle arthroplastyMetacarpophalangeal joint, no implant
- 26530 is arthroplasty of a metacarpophalangeal joint. It addresses the joint with an arthroplasty procedure, not ligament reconstruction.
26545 billing questions
How is this different from a direct ligament repair?
Use this code when the surgeon reconstructs the ligament with graft tissue. A direct repair of the existing ligament is a different service.
Does the code include obtaining the graft?
The operative documentation should identify the graft and the reconstruction performed. Check the applicable CPT descriptor and coding guidance before separately reporting graft procurement.
Can modifier 50 be used for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not apply.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant-at-surgery be paid?
CMS payment for an assistant at surgery 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
Fee sheets · Coming soon
Put 26545 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist