CPT code 26607: Metacarpal fracture, manipulation with percutaneous fixation2026 Medicare rate & RVUs in Missouri
Report this service for a metacarpal fracture treated by closed manipulation and percutaneous skeletal fixation of the affected bone.
CMS doesn’t publish an office rate for 26607 in Missouri.
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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On this page 9 sections
What 26607 covers
This service treats a metacarpal fracture without open exposure of the fracture site. The clinician manipulates the fracture into position and stabilizes it with percutaneous skeletal fixation, such as pins placed through the skin. It is typically performed by an orthopedic or hand surgeon when closed reduction alone is not sufficient to maintain alignment. The code is reported for each bone treated, so documentation should identify the metacarpal, fracture, reduction, and fixation performed.
This major surgery code has 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% reduction. Modifier 50 is inappropriate for this code’s anatomy or descriptor. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted. The operative report should establish that closed manipulation and percutaneous fixation were performed, distinguishing this service from closed treatment without fixation or open fracture treatment.
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 26607 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.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $479.33 |
| Metropolitan St. Louis, MO | Unavailable | $483.93 |
| Rest of Missouri | Unavailable | $457.58 |
How the 26607 rate is calculated
Each of 26607’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 · 26607
RVUs × geographic indexes × conversion factor
Work5.34
5.34 RVUs× 1.000 GPCI
Practice expense8.41
8.41 RVUs× 1.000 GPCI
Malpractice1.14
1.14 RVUs× 1.000 GPCI
Adjusted RVUs
14.8900
Conversion factor
$33.4009
Medicare rate
$497.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26607
26607 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26607
Metacarpal fracture, manipulation with percutaneous fixation
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 26607
Metacarpal fracture, manipulation with percutaneous fixation
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
26607 without 51 · national facility
$497.34
Metacarpal fracture, manipulation with percutaneous fixation
26607-51 · Second procedure: 50%
$248.67
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%).
26607 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26600Metacarpal fracture careSingle bone, no manipulation
- 26600 describes closed treatment without manipulation. 26607 involves manipulation and percutaneous skeletal fixation.
- 26605Metacarpal fractureClosed treatment with manipulation
- 26605 describes closed treatment with manipulation but without percutaneous skeletal fixation. 26607 includes manipulation requiring percutaneous fixation.
- 26608Metacarpal fracturePercutaneous skeletal fixation
- Both codes are in the metacarpal fixation family. Match the code to the full descriptor and the exact closed-treatment and fixation work documented.
- 26615Metacarpal fractureOpen treatment, each bone
- 26615 is for open treatment of a metacarpal fracture. 26607 describes closed manipulation with percutaneous skeletal fixation.
26607 billing questions
How is 26607 different from 26605?
26607 describes closed manipulation with percutaneous skeletal fixation. Use 26605 when the metacarpal fracture is manipulated but does not require percutaneous skeletal fixation.
How is 26607 different from 26608?
26607 specifies closed treatment with manipulation requiring percutaneous skeletal fixation. Compare the documented procedure with the full descriptors for 26607 and 26608 to select the code matching the fixation service performed.
Is the code reported once per hand or once per bone?
The service is reported for each metacarpal bone treated. Identify the treated bone or bones in the operative documentation.
Are related postoperative visits separately reported during the global period?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
Can modifier 50 be used when both hands are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 is not appropriate for its descriptor or anatomy.
When can an assistant-at-surgery be paid?
Assistant-at-surgery payment requires documentation supporting medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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