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CPT code 26565: Metacarpal osteotomy, deformity correction2026 Medicare rate & RVUs

Reports surgical cutting and realignment of a metacarpal to correct a bone deformity, such as angular or rotational malalignment.

CMS RVU26DEffective Oct 1, 2026109 payment localities150 Medicare services in 2024

Medicare pays $690.40 for 26565 nationally in a facility.

Medicare rate · 26565

Metacarpal osteotomy, deformity correction

Office or facility?

Work RVUs
6.74
Total RVUs
20.67
Global days
090

National rate · 2026

$690.40

Facility setting, before claim adjustments.

See every locality for 26565 →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 26565 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 26565 covers

A hand or orthopedic surgeon performs this osteotomy to change the alignment or shape of a metacarpal. It may be used for a structural deformity that interferes with hand position or function. The surgeon plans and makes a bone cut, then stabilizes the corrected position when needed. These procedures are commonly performed in a hospital outpatient department or ambulatory surgery center.

Select the code when the operative work is an osteotomy of a metacarpal for deformity correction; document the bone treated, the deformity, the corrective plan, and any fixation. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery services 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 26565 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

26565 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$618.72
AlaskaUnavailable$810.71
ArizonaUnavailable$671.03
ArkansasUnavailable$609.74
Atlanta, GAUnavailable$706.61
Austin, TXUnavailable$710.31
Bakersfield, CAUnavailable$718.03
Baltimore area, MDUnavailable$735.14
Beaumont, TXUnavailable$649.35
Brazoria, TXUnavailable$678.78

26565 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
26565 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 26565 rate is calculated

Each of 26565’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 · 26565

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.74

6.74 RVUs× 1.000 GPCI

Practice expense12.62

12.62 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

20.6700

Conversion factor

$33.4009

Medicare rate

$690.40

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

Payment rules and modifiers for 26565

26565 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26565

Metacarpal osteotomy, deformity correction

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)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 · 26565

Metacarpal osteotomy, deformity correction

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

26565 without 51 · national facility

$690.40

Metacarpal osteotomy, deformity correction

26565-51 · Second procedure: 50%

$345.20

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

26565 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 26565

    Metacarpal osteotomy, deformity correction6.74 wRVU

    Not priced

  • 26567

    Finger osteotomy, phalanx deformity correction6.82 wRVU

    Not priced

  • 26568

    Bone lengthening, metacarpal or phalanx9.04 wRVU

    Not priced

  • 26546

    Metacarpal repair, nonunion or malunion10.56 wRVU

    Not priced

How to choose

26567Finger osteotomyPhalanx deformity correction
Use 26565 for an osteotomy of a metacarpal. Use 26567 for an osteotomy of a finger phalanx.
26568Bone lengtheningMetacarpal or phalanx
Use 26568 when the procedure is metacarpal lengthening. Use 26565 for corrective metacarpal osteotomy when lengthening is not the defining objective.
26546Metacarpal repairNonunion or malunion
Use 26546 for repair of metacarpal nonunion or malunion. Use 26565 for an osteotomy performed to correct a metacarpal deformity.

Codes related to 26565

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

Codes related to 26565
CodeHow it relatesNational office range
Same family
26567Finger osteotomy, phalanx deformity correctionOsteotomy of a finger phalanx rather than a metacarpal.No office rate
Used instead
26568Bone lengthening, metacarpal or phalanxMetacarpal lengthening service when lengthening is the operative objective.No office rate
26546Metacarpal repair, nonunion or malunionRepair of metacarpal nonunion or malunion, with or without bone graft.No office rate

26565 billing questions

How is this different from a phalangeal osteotomy?

This code is for an osteotomy of a metacarpal, the long bone in the palm. CPT 26567 is for an osteotomy of a finger phalanx.

Is fixation separately reported when used?

Fixation used to hold the metacarpal in its corrected position is part of the osteotomy service. Document the fixation performed in the operative report.

When should a metacarpal nonunion repair code be considered instead?

Consider CPT 26546 when the operation repairs an established metacarpal nonunion or malunion. Use 26565 when the documented work is an osteotomy to correct a metacarpal deformity.

Can modifier 50 be used for osteotomies on both hands?

CMS identifies modifier 50 as inappropriate for this descriptor and anatomy. Do not use it to claim a bilateral adjustment for this service.

What postoperative care is included?

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

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 26565PPRRVU2026_Oct_nonQPP.csv, line 2,649 (RVU26D)

Open CMS sourceHow we calculate rates

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