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CPT code 26550: Thumb reconstruction, finger-to-thumb repositioning2026 Medicare rate & RVUs

Reports surgery that repositions an existing finger, typically the index finger, into the thumb position to create a functional opposable thumb.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,538.45 for 26550 nationally in a facility.

Medicare rate · 26550

Thumb reconstruction, finger-to-thumb repositioning

Office or facility?

Work RVUs
21.14
Total RVUs
46.06
Global days
090

National rate · 2026

$1,538.45

Facility setting, before claim adjustments.

See every locality for 26550 →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 26550 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 26550 covers

A hand surgeon uses an existing finger, usually the index finger, to create a thumb when the thumb is absent or severely underdeveloped. The operation moves and reshapes the digit into the thumb position, with adjustments to its bones, tendons, nerves, blood supply, and surrounding skin to support opposition and grasp. It is performed in an operating room, commonly for congenital hand differences such as thumb hypoplasia or absence.

Report the code when the operative work is pollicization, rather than a toe-to-hand transfer or a less extensive change in finger position. The operative report should identify the digit moved, the recipient thumb position, laterality, and reconstructive work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 26550 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

26550 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,387.96
AlaskaUnavailable$1,868.34
ArizonaUnavailable$1,495.66
ArkansasUnavailable$1,369.38
Atlanta, GAUnavailable$1,581.69
Austin, TXUnavailable$1,562.28
Bakersfield, CAUnavailable$1,558.57
Baltimore area, MDUnavailable$1,635.15
Beaumont, TXUnavailable$1,466.39
Brazoria, TXUnavailable$1,504.89

26550 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
26550 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 26550 rate is calculated

Each of 26550’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 · 26550

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.14

21.14 RVUs× 1.000 GPCI

Practice expense20.42

20.42 RVUs× 1.000 GPCI

Malpractice4.50

4.50 RVUs× 1.000 GPCI

Adjusted RVUs

46.0600

Conversion factor

$33.4009

Medicare rate

$1,538.45

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

Payment rules and modifiers for 26550

26550 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26550

Thumb reconstruction, finger-to-thumb repositioning

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
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 · 26550

Thumb reconstruction, finger-to-thumb repositioning

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 50 · payment effect

With and without the modifier

26550 without 50 · national facility

$1,538.45

Thumb reconstruction, finger-to-thumb repositioning

26550-50 · Bilateral: 150%

$2,307.68

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

26550 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26550

    Thumb reconstruction, finger-to-thumb repositioning21.14 wRVU

    Not priced

  • 26551

    Toe-to-hand transfer, great toe47.27 wRVU

    Not priced

  • 26553

    Toe-hand transfer, single toe46.97 wRVU

    Not priced

  • 26555

    Finger transfer, single finger repositioning16.65 wRVU

    Not priced

How to choose

26551Toe-to-hand transferGreat toe
Choose 26551 when the great toe is transferred to the hand. Code 26550 repositions an existing finger to form a thumb.
26553Toe-hand transferSingle toe
26553 describes a single toe transferred to the hand; 26550 uses a finger already on the hand to create the thumb.
26555Finger transferSingle finger repositioning
26555 covers repositioning a finger when the operation is not pollicization to create a thumb.

Codes related to 26550

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

Codes related to 26550
CodeHow it relatesNational office range
Used instead
26551Toe-to-hand transfer, great toeUsed for a great-toe transfer from the foot to the hand, rather than repositioning an existing finger.No office rate
26553Toe-hand transfer, single toeReports a single toe transferred from the foot to the hand.No office rate
26555Finger transfer, single finger repositioningFor changing a finger's position without the thumb-reconstruction work of pollicization.No office rate

26550 billing questions

When should 26550 be chosen instead of a toe-to-hand transfer code?

Use 26550 when an existing finger is repositioned to create the thumb. A toe transferred from the foot to the hand is a different operation, represented by codes such as 26551 or 26553.

How does 26550 differ from 26555?

26550 describes converting a digit into a thumb at the thumb position. Consider 26555 when the operation changes a finger's position but does not perform pollicization.

What documentation supports reporting 26550?

Document the thumb deficiency or absence, the digit used, its new position, laterality, and the reconstructive steps performed to create thumb function.

How are bilateral procedures and other same-session procedures paid?

CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.

What postoperative care is included, and may an assistant be paid?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid; 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 26550PPRRVU2026_Oct_nonQPP.csv, line 2,640 (RVU26D)

Open CMS sourceHow we calculate rates

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