CPT code 26608: Metacarpal fracture, percutaneous skeletal fixation2026 Medicare rate & RVUs in Texas
Closed treatment of a metacarpal fracture with manipulation and percutaneous skeletal fixation, reported for each metacarpal bone treated.
CMS doesn’t publish an office rate for 26608 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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On this page 9 sections
What 26608 covers
This service treats a metacarpal fracture by manipulating the bone into alignment and stabilizing it with percutaneous skeletal fixation, such as pins placed through the skin. An orthopedic or hand surgeon typically performs the reduction and fixation in an operating room or other procedural setting. The fracture is treated without open exposure of the fracture site; when the surgeon exposes and treats the fracture directly, a different code family member is used.
Report this code for each metacarpal bone treated when both manipulation and percutaneous skeletal fixation are performed. The record should identify the fractured bone, describe the reduction and fixation method, and support the need for stabilization. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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. Assistant-at-surgery payment requires documented medical necessity; 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 26608 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 | $474.93 |
| Beaumont, TX | Unavailable | $439.43 |
| Brazoria, TX | Unavailable | $455.63 |
| Dallas, TX | Unavailable | $459.83 |
| Fort Worth, TX | Unavailable | $457.82 |
| Galveston, TX | Unavailable | $457.84 |
| Houston, TX | Unavailable | $477.42 |
| Rest of Texas | Unavailable | $448.17 |
How the 26608 rate is calculated
Each of 26608’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 · 26608
RVUs × geographic indexes × conversion factor
Work5.41
5.41 RVUs× 1.000 GPCI
Practice expense7.42
7.42 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
13.9000
Conversion factor
$33.4009
Medicare rate
$464.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26608
26608 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26608
Metacarpal fracture, percutaneous skeletal 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 · 26608
Metacarpal fracture, percutaneous skeletal 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
26608 without 51 · national facility
$464.27
Metacarpal fracture, percutaneous skeletal fixation
26608-51 · Second procedure: 50%
$232.14
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%).
26608 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26605Metacarpal fractureClosed treatment with manipulation
- 26605 covers manipulation without percutaneous skeletal fixation. Choose 26608 when fixation is also performed through the skin.
- 26607Metacarpal fractureManipulation with percutaneous fixation
- Both include manipulation and fixation, but 26607 uses external fixation; 26608 uses percutaneous skeletal fixation.
- 26615Metacarpal fractureOpen treatment, each bone
- 26615 is for open treatment of the metacarpal fracture. Choose 26608 when treatment uses manipulation and percutaneous fixation without open exposure.
26608 billing questions
When should 26608 be selected instead of 26605?
Use 26608 when the metacarpal fracture is manipulated and stabilized with percutaneous skeletal fixation. Use 26605 for manipulation without that fixation.
How is this code different from 26607?
Both include manipulation and fixation, but 26608 represents percutaneous skeletal fixation. Code 26607 is for treatment using external fixation.
Is the code reported once per fracture or once per bone?
Report it for each metacarpal bone treated. The operative documentation should identify each bone receiving manipulation and percutaneous fixation.
Can modifier 50 be used for fractures in both hands?
No. Modifier 50 is inappropriate for this code under the CMS bilateral adjustment facts.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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