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CPT code 26600: Metacarpal fracture care, single bone, no manipulation2026 Medicare rate & RVUs in Hawaii, Guam, HI

Closed treatment of one metacarpal fracture without manipulation, typically used when the treating clinician immobilizes the fracture without repositioning it.

CMS RVU26DEffective Oct 1, 2026One payment locality9.5K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $367.75 for 26600 in the office and $321.04 when it’s performed in a hospital or facility.

$367.75Office (non-facility)
$321.04Hospital or facility
+7.6%vs the national office rate ($341.69)

Check a contract rate as a % of Medicare · 26600 nationwide

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

We’ll open 26600 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 26600 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 26600 covers

This code describes closed care for a fracture of one metacarpal when the clinician does not manipulate the bone to reduce or reposition it. Orthopedic and hand surgeons commonly provide this care, as may other clinicians who manage acute hand fractures, in an office, emergency department, or facility setting. Treatment may include stabilizing the hand with an appropriate splint or cast and arranging fracture follow-up.

Select this code when documentation supports treatment of one metacarpal fracture without manipulation; use the multiple-fracture code family when more than one metacarpal is treated. Record the injured bone, fracture findings, treatment plan, and immobilization. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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.

How Hawaii, Guam, HI compares for 26600

Across 109 of 109 payment localities, the office rate for 26600 runs from $299.84 in Arkansas to $449.72 in San Benito County, CA. Hawaii, Guam, HI pays $367.75. The RVUs are the same everywhere; the geographic indexes change the dollars.

26600 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$367.75
  2. Los Angeles, CA · California$383.68+$15.93
  3. Washington, DC area · District of Columbia$390.93+$23.18
  4. Miami, FL · Florida$376.58+$8.83
  5. Chicago, IL · Illinois$364.68−$3.07
  6. Manhattan, NY · New York$395.67+$27.92
  7. Alaska · Alaska$392.39+$24.64

Other areas in Hawaii first, then benchmark localities. Bars start at $0.

Every other payment area

26600 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$304.53$268.58
ArkansasArkansas$299.84$264.55
ArizonaArizona$331.88$292.07
Bakersfield, CACalifornia$359.99$314.96
Chico, CACalifornia$358.63$313.60
El Centro, CACalifornia$358.71$313.68
Fresno, CACalifornia$358.63$313.60
Hanford, CACalifornia$358.63$313.60

26600 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$299.84

$404.18

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
26600 office rate range by state
State / territoryOffice rate rangeLocalities
AK$392.391
AL$304.531
AR$299.841
AZ$331.881
CA$358.63–$449.7229
CO$354.521
CT$365.341
DC$390.931
DE$337.581
FL$339.34–$376.583
GA$318.86–$349.082
GU$367.751
HI$367.751
IA$311.381
ID$313.831
IL$329.98–$364.684
IN$315.721
KS$310.491
KY$313.611
LA$313.35–$329.732
MA$352.47–$390.022
MD$344.08–$390.933
ME$316.27–$333.492
MI$322.88–$344.502
MN$337.141
MO$308.08–$330.183
MS$303.991
MT$341.661
NC$319.671
ND$331.971
NE$312.991
NH$349.511
NJ$368.80–$386.632
NM$325.021
NV$339.201
NY$324.81–$406.605
OH$320.901
OK$312.311
OR$335.87–$365.552
PA$321.07–$356.242
PR$344.091
RI$349.471
SC$320.961
SD$330.821
TN$312.231
TX$318.89–$353.948
UT$325.591
VA$332.79–$390.932
VI$344.091
VT$331.201
WA$351.63–$397.532
WI$320.271
WV$317.241
WY$337.441

See 26600 in every payment locality

How the 26600 rate is calculated

Each of 26600’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 · 26600

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.54

2.54 RVUs× 1.000 GPCI

Practice expense7.20

7.20 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

10.2300

Conversion factor

$33.4009

Medicare rate

$341.69

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,658

Code
26600
Physician work
2.54
Practice expense
7.20
Malpractice
0.49

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 26600 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work2.54× 1.0002.5400
Practice expense7.20× 1.1378.1864
Malpractice0.49× 0.5790.2837
Total RVUs11.0101
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$367.75

Office: (2.54 × 1 + 7.2 × 1.137 + 0.49 × 0.579) × $33.4009 = $367.75

Facility: (2.54 × 1 + 5.97 × 1.137 + 0.49 × 0.579) × $33.4009 = $321.04

Open 26600 in the RVU calculator

Payment rules and modifiers for 26600

26600 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26600

Metacarpal fracture care, single bone, no manipulation

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)1Not paid (statutory restriction).
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 · 26600

Metacarpal fracture care, single bone, no manipulation

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

26600 without 51 · national office

$341.69

Metacarpal fracture care, single bone, no manipulation

26600-51 · Second procedure: 50%

$170.85

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

Codes related to 26600

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

Codes related to 26600
CodeHow it relatesOffice range, Hawaii, Guam, HI
Same family
26605Metacarpal fracture, closed treatment with manipulationSingle metacarpal fracture treatment when manipulation is performed.$403.13
26607Metacarpal fracture, manipulation with percutaneous fixationMultiple metacarpal fractures treated without manipulation.No office rate
26608Metacarpal fracture, percutaneous skeletal fixationMultiple metacarpal fractures treated with manipulation.No office rate
Used instead
26615Metacarpal fracture, open treatment, each boneOpen treatment of a metacarpal fracture rather than closed treatment.No office rate

How 26600 has changed in Hawaii, Guam, HI

26600 · Office / nonfacility

$367.75

Effective 2026-10-01

The base rate is $33.37 higher than on 2025-10-01, moving from $334.38 to $367.75 (10.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $334.38changed to$367.75

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.60 changed to 2.54
    • Practice expense RVU 6.49 changed to 7.20
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $339.52changed to$334.38

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.37 changed to 6.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $333.98changed to$339.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $339.41changed to$333.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.20 changed to 6.37
    • Malpractice RVU 0.49 changed to 0.50
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $338.30changed to$339.41

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.96 changed to 6.20
    • Malpractice RVU 0.50 changed to 0.49
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $335.45changed to$338.30

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.83 changed to 5.96
    • Malpractice RVU 0.48 changed to 0.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $329.32changed to$335.45

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.42 changed to 5.83
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $324.68changed to$329.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.36 changed to 5.42
    • Malpractice RVU 0.43 changed to 0.48
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $325.79changed to$324.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.39 changed to 5.36
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $322.95changed to$325.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.30 changed to 5.39
    • Malpractice RVU 0.45 changed to 0.44
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $323.83changed to$322.95

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $325.00changed to$323.83

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $323.38changed to$325.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $321.55changed to$323.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.24 changed to 5.30
    • Malpractice RVU 0.46 changed to 0.45
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $328.01changed to$321.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.81 changed to 5.24
    • Malpractice RVU 0.48 changed to 0.46
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$328.01

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$367.75$321.04RVU26D
2026-07-01$367.75$321.04RVU26C
2026-04-01$367.75$321.04RVU26B
2026-01-01$367.75$321.04RVU26A
2025-10-01$334.38$318.03RVU25D
2025-07-01$334.38$318.03RVU25C
2025-04-01$334.38$318.03RVU25B
2025-01-01$334.38$318.03RVU25A
2024-10-01$339.52$322.31RVU24D
2024-07-01$339.52$322.31RVU24C
2024-04-01$339.52$322.31RVU24B
2024-03-09$339.52$322.31RVU24AR
2024-01-01$333.98$317.05RVU24A
2023-10-01$339.41$321.93RVU23D
2023-07-01$339.41$321.93RVU23C
2023-04-01$339.41$321.93RVU23B
2023-01-01$339.41$321.93RVU23A
2022-10-01$338.30$320.90RVU22D
2022-07-01$338.30$320.90RVU22C
2022-04-01$338.30$320.90RVU22B
2022-01-01$338.30$320.90RVU22A
2021-10-01$335.45$317.11RVU21D
2021-07-01$335.45$317.11RVU21C
2021-04-01$335.45$317.11RVU21B
2021-01-01$335.45$317.11RVU21A
2020-10-01$329.32$311.16RVU20D
2020-07-01$329.32$311.16RVU20C
2020-04-01$329.32$311.16RVU20B
2020-01-01$329.32$311.16RVU20A
2019-10-01$324.68$306.10RVU19D
2019-07-01$324.68$306.10RVU19C
2019-04-01$324.68$306.10RVU19B
2019-01-01$324.68$306.10RVU19A
2018-10-01$325.79$304.33RVU18D
2018-07-01$325.79$304.33RVU18C
2018-04-01$325.79$304.33RVU18B
2018-01-01$325.79$304.33RVU18AR1
2017-10-01$322.95$302.65RVU17D
2017-07-01$322.95$302.65RVU17C
2017-04-01$322.95$302.65RVU17B
2017-01-01$322.95$302.65RVU17A
2016-10-01$323.83$303.86RVU16D
2016-07-01$323.83$303.86RVU16C
2016-04-01$323.83$303.86RVU16B
2016-01-01$323.83$303.86RVU16A
2015-10-01$325.00$304.54RVU15D
2015-07-01$325.00$304.54RVU15C
2015-04-01$323.38$303.03RVU15B
2015-01-01$323.38$303.03RVU15A
2014-10-01$321.55$302.06RVU14D
2014-07-01$321.55$302.06RVU14C
2014-04-01$321.55$302.06RVU14B
2014-01-01$321.55$302.06RVU14A
2013-10-01$328.01$307.20RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 26600 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

26600 billing questions

When should 26600 be chosen over 26605?

Use 26600 when one metacarpal fracture is treated without manipulation. Use 26605 when the clinician manipulates the fracture.

How does 26600 differ from 26607?

26600 is for treatment of a single metacarpal fracture. The 26607 family addresses multiple metacarpal fractures treated without manipulation.

Can the initial cast or splint be billed separately?

Routine initial immobilization associated with the fracture treatment is generally included in the fracture-care service. Document the immobilization and treatment plan.

Can modifier 50 be used for fractures in both hands?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What documentation supports reporting 26600?

Document the metacarpal involved, the fracture diagnosis and findings, that one bone is being treated, and that no manipulation was 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

Show the CMS file lines behind this rate
RVUs for 26600PPRRVU2026_Oct_nonQPP.csv, line 2,658 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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