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

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

CMS RVU26DEffective Oct 1, 20263 payment localities9.5K Medicare services in 2024

Medicare pays $308.08–$330.18 for 26600 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.

$308.08–$330.18Office (non-facility)
$272.66–$291.07Hospital or facility

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 9 sections
  1. Rate in Missouri
  2. What 26600 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

Where 26600 pays more and less in Missouri

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$308.08 to $330.18

$308.08$319.13$330.18
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
26600 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Kansas City, MO$326.65$288.07
Metropolitan St. Louis, MO$330.18$291.07
Rest of Missouri$308.08$272.66

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.

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

26600 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 26600

    Metacarpal fracture care, single bone, no manipulation2.54 wRVU

    $341.69

  • 26605

    Metacarpal fracture, closed treatment with manipulation2.95 wRVU

    $376.43+$34.74

  • 26607

    Metacarpal fracture, manipulation with percutaneous fixation5.34 wRVU

    Not priced

  • 26608

    Metacarpal fracture, percutaneous skeletal fixation5.41 wRVU

    Not priced

  • 26615

    Metacarpal fracture, open treatment, each bone6.89 wRVU

    Not priced

How to choose

26605Metacarpal fractureClosed treatment with manipulation
Both concern treatment of a single metacarpal fracture; 26605 is selected when the fracture is manipulated, while 26600 is for treatment without manipulation.
26607Metacarpal fractureManipulation with percutaneous fixation
26607 is used for multiple metacarpal fractures treated without manipulation; 26600 is for a single metacarpal fracture.
26608Metacarpal fracturePercutaneous skeletal fixation
26608 addresses multiple metacarpal fractures treated with manipulation. 26600 is for a single fracture treated without manipulation.
26615Metacarpal fractureOpen treatment, each bone
26615 describes open treatment of a metacarpal fracture. Choose 26600 for closed treatment of one bone without manipulation.

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)

Open CMS sourceHow we calculate rates

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