CPT code 26568: Bone lengthening, metacarpal or phalanx2026 Medicare rate & RVUs in Texas
Reports operative lengthening of a metacarpal or finger phalanx, such as correction of a congenitally short bone or acquired shortening.
CMS doesn’t publish an office rate for 26568 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 26568 covers
A hand surgeon lengthens a metacarpal or phalanx when a bone is abnormally short and length restoration is part of the treatment plan. Typical situations include congenital shortening, such as brachymetacarpia, and shortening after injury. The procedure is generally performed in an operating room by an orthopedic or plastic surgeon with hand-surgery expertise; the operative approach may use an osteotomy and a method of gradual or immediate lengthening.
Choose this code for the lengthening procedure, not simply because an osteotomy is performed. The operative report should identify the bone treated, the reason for lengthening, the correction performed, and the method used. 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 multiple-procedure reduction. Modifier 50 is inappropriate. 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 26568 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $936.09 |
| Beaumont, TX | Unavailable | $857.56 |
| Brazoria, TX | Unavailable | $894.58 |
| Dallas, TX | Unavailable | $902.61 |
| Fort Worth, TX | Unavailable | $897.99 |
| Galveston, TX | Unavailable | $898.75 |
| Houston, TX | Unavailable | $933.89 |
| Rest of Texas | Unavailable | $877.16 |
How the 26568 rate is calculated
Each of 26568’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 · 26568
RVUs × geographic indexes × conversion factor
Work9.04
9.04 RVUs× 1.000 GPCI
Practice expense16.32
16.32 RVUs× 1.000 GPCI
Malpractice1.92
1.92 RVUs× 1.000 GPCI
Adjusted RVUs
27.2800
Conversion factor
$33.4009
Medicare rate
$911.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26568
26568 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26568
Bone lengthening, metacarpal or phalanx
| 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) | 2 | Paid. |
| 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 · 26568
Bone lengthening, metacarpal or phalanx
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
26568 without 51 · national facility
$911.18
Bone lengthening, metacarpal or phalanx
26568-51 · Second procedure: 50%
$455.59
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%).
26568 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26565Metacarpal osteotomyDeformity correction
- Use 26565 for shortening a metacarpal. Use 26568 when the operation lengthens a metacarpal or phalanx.
- 26567Finger osteotomyPhalanx deformity correction
- Use 26567 for shortening a phalanx. It is not the code for lengthening a short finger bone.
- 26548Finger joint reconstructionLocal tissue technique
- 26548 addresses metacarpal deformity correction by osteotomy. Choose 26568 when the documented procedure lengthens the metacarpal or phalanx.
- 26546Metacarpal repairNonunion or malunion
- 26546 addresses nonunion or malunion of a metacarpal or phalanx; 26568 describes lengthening rather than repair of a failed or malunited bone.
26568 billing questions
When should I report 26568 instead of a shortening osteoplasty?
Report 26568 when the operation lengthens a metacarpal or phalanx. Codes 26565 and 26567 describe shortening procedures, not lengthening.
What operative documentation supports this code?
Document the bone treated, the cause of its short length, the lengthening performed, and the operative method. The record should make clear that length restoration—not only correction of alignment—was performed.
Can modifier 50 be used when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS treats 26568 as major surgery.
Can an assistant surgeon be paid for this procedure?
CMS permits assistant-at-surgery payment for 26568. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures performed in that session are subject to a 50% 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
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