CPT code 26605: Metacarpal fracture, closed treatment with manipulation2026 Medicare rate & RVUs

Medicare pays $376.43 for 26605 nationally in the office and $311.96 in a hospital or facility. Local office rates run $330.24–$491.64.

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

What 26605 covers

An orthopedic or hand surgeon, and sometimes an emergency physician, manipulates a fractured metacarpal to restore alignment without surgically exposing the fracture. The clinician typically confirms the reduction with imaging and immobilizes the hand in a splint or cast. Common clinical settings include an office, emergency department, or facility where the fracture can be reduced and stabilized without open surgery.

Select this code when the physician performs closed reduction; a fracture treated without manipulation belongs to a different code. Document the metacarpal treated, fracture findings, the reduction maneuver and resulting alignment, and immobilization. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 26605 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

26605 rates by state

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

How the 26605 rate is calculated

Each of 26605’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.

Payment rules and modifiers for 26605

26605 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

26605 compared with similar codes

How to choose

26600Metacarpal fracture careSingle bone, no manipulation

Choose 26600 when closed treatment does not involve manipulation; 26605 requires a reduction maneuver.

26607Metacarpal fractureManipulation with percutaneous fixation

Both concern metacarpal fractures, but 26607 represents a different treatment specification. Verify the method and circumstances documented before choosing between them.

26608Metacarpal fracturePercutaneous skeletal fixation

26608 describes percutaneous skeletal fixation. Use 26605 for closed manipulation without that fixation approach.

26615Metacarpal fractureOpen treatment, each bone

26615 is for open fracture treatment. This code describes reduction without surgically exposing the fracture.

Codes related to 26605

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

Open CMS sourceHow we calculate rates