CPT code 26546: Metacarpal repair, nonunion or malunion2026 Medicare rate & RVUs

Medicare pays $993.34 for 26546 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 26546 covers

A hand surgeon uses this service to address a metacarpal fracture that has not united or has healed in a position that impairs hand function. The operation may involve preparing the fracture site, restoring alignment, and stabilizing the bone; bone graft may be used when needed. Typical cases include a symptomatic fracture nonunion or a malunion that affects finger alignment, grip, or hand use. These repairs are generally performed in an operating room.

Report the code for repair of the established metacarpal nonunion or malunion, rather than treatment of an acute fracture. The operative note should identify the metacarpal, describe the nonunion or deformity and its functional significance, and document the repair and fixation; include graft use when performed. Bone graft use is included in this service. CMS 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 applies to bilateral reporting, paid at 150%. Assistant-at-surgery payment may be made; 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 26546 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

26546 rates by state

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

How the 26546 rate is calculated

Each of 26546’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.

Payment rules and modifiers for 26546

26546 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

26546 compared with similar codes

How to choose

26615Metacarpal fractureOpen treatment, each bone

Use 26615 for open treatment of an acute metacarpal fracture. Use 26546 when the fracture has become an established nonunion or malunion requiring repair.

26600Metacarpal fracture careSingle bone, no manipulation

Code 26600 describes closed treatment without manipulation of an acute metacarpal fracture; 26546 addresses repair of an established nonunion or malunion.

26605Metacarpal fractureClosed treatment with manipulation

Code 26605 is closed treatment with manipulation for an acute metacarpal fracture. It is not the repair code for a fracture that has failed to unite or healed in a deformity.

26565Metacarpal osteotomyDeformity correction

Code 26565 is for corrective metacarpal osteotomy. Choose 26546 when the operative problem is an established metacarpal fracture nonunion or malunion.

Codes related to 26546

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

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

Open CMS sourceHow we calculate rates