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CPT code 26700: MCP dislocation, without manipulation2026 Medicare rate & RVUs in Puerto Rico

Reports closed treatment of a metacarpophalangeal joint dislocation when the provider manages the dislocation without manipulating or reducing the joint.

CMS RVU26DEffective Oct 1, 2026One payment locality467 Medicare services in 2024

In Puerto Rico, Medicare pays $409.21 for 26700 in the office and $350.11 when it’s performed in a hospital or facility.

$409.21Office (non-facility)
$350.11Hospital or facility
+0.6%vs the national office rate ($406.82)

Check a contract rate as a % of Medicare · 26700 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 26700 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 26700 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 26700 covers

This code describes closed management of a dislocated metacarpophalangeal (MCP) joint in a finger, without manipulation. It may be used when the joint is already aligned, such as after spontaneous reduction, and the provider proceeds with closed treatment and immobilization. Orthopedic and hand surgeons commonly provide this care; emergency physicians may also manage acute hand injuries. The code is for an MCP joint, not a proximal or distal interphalangeal joint.

Report one unit for each MCP joint treated. Documentation should identify the affected joint, establish the dislocation, and show that closed treatment was provided without manipulation. If the provider manipulates the joint to reduce it, consider 26705 instead. CMS assigns a 90-day global period, including 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 others at 50%. Modifier 50 is inappropriate for this code; assistant-at-surgery payment is restricted, 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.

How Puerto Rico compares for 26700

Across 109 of 109 payment localities, the office rate for 26700 runs from $357.49 in Arkansas to $520.16 in San Benito County, CA. Puerto Rico pays $409.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

26700 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$409.21
  2. Los Angeles, CA · California$449.19+$39.98
  3. Washington, DC area · District of Columbia$461.99+$52.78
  4. Miami, FL · Florida$459.65+$50.44
  5. Chicago, IL · Illinois$444.87+$35.66
  6. Manhattan, NY · New York$472.27+$63.06
  7. Alaska · Alaska$473.21+$64.00

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

Every other payment area

26700 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$362.98$311.83
ArkansasArkansas$357.49$307.28
ArizonaArizona$394.94$338.30
Bakersfield, CACalifornia$422.78$358.72
Chico, CACalifornia$420.51$356.45
El Centro, CACalifornia$420.65$356.59
Fresno, CACalifornia$420.51$356.45
Hanford, CACalifornia$420.51$356.45

26700 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.

$357.49

$473.21

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

View every state and territory as a table
26700 office rate range by state
State / territoryOffice rate rangeLocalities
AK$473.211
AL$362.981
AR$357.491
AZ$394.941
CA$420.51–$520.1629
CO$418.541
CT$434.731
DC$461.991
DE$401.591
FL$409.57–$459.653
GA$384.66–$416.842
GU$430.021
HI$430.021
IA$368.471
ID$371.851
IL$400.29–$444.874
IN$373.991
KS$368.641
KY$376.221
LA$376.39–$395.582
MA$416.68–$458.262
MD$408.85–$461.993
ME$375.98–$394.302
MI$388.26–$416.932
MN$394.691
MO$370.98–$394.663
MS$364.211
MT$406.771
NC$379.761
ND$390.361
NE$369.981
NH$413.791
NJ$437.91–$457.282
NM$391.271
NV$402.451
NY$385.86–$486.665
OH$384.901
OK$373.411
OR$397.57–$429.972
PA$384.43–$424.852
PR$409.211
RI$414.601
SC$383.321
SD$388.421
TN$370.831
TX$381.95–$418.678
UT$388.721
VA$394.35–$461.992
VI$409.211
VT$390.581
WA$415.31–$465.752
WI$376.951
WV$385.431
WY$399.621

See 26700 in every payment locality

How the 26700 rate is calculated

Each of 26700’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 · 26700

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.73

3.73 RVUs× 1.000 GPCI

Practice expense7.62

7.62 RVUs× 1.000 GPCI

Malpractice0.83

0.83 RVUs× 1.000 GPCI

Adjusted RVUs

12.1800

Conversion factor

$33.4009

Medicare rate

$406.82

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,672

Code
26700
Physician work
3.73
Practice expense
7.62
Malpractice
0.83

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 26700 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.73× 1.0003.7300
Practice expense7.62× 1.0117.7038
Malpractice0.83× 0.9850.8175
Total RVUs12.2514
Conversion factor× 33.4009

Office rate, Puerto Rico$409.21

Office: (3.73 × 1 + 7.62 × 1.011 + 0.83 × 0.985) × $33.4009 = $409.21

Facility: (3.73 × 1 + 5.87 × 1.011 + 0.83 × 0.985) × $33.4009 = $350.11

Open 26700 in the RVU calculator

Payment rules and modifiers for 26700

26700 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26700

MCP dislocation, without 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 · 26700

MCP dislocation, without 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

26700 without 51 · national office

$406.82

MCP dislocation, without manipulation

26700-51 · Second procedure: 50%

$203.41

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 26700

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

Codes related to 26700
CodeHow it relatesOffice range, Puerto Rico
Same family
26705Knuckle reduction, manipulation requiring anesthesiaClosed treatment of an MCP dislocation when manipulation is performed.$491.67
Used instead
26706Knuckle dislocation, percutaneous fixationUsed for MCP dislocation treatment requiring percutaneous skeletal fixation.No office rate
26715Knuckle dislocation, open treatment, single jointUsed when an MCP dislocation requires open treatment.No office rate
26770Finger dislocation, without anesthesiaTreats a finger joint dislocation at a different joint level.$363.98

How 26700 has changed in Puerto Rico

26700 · Office / nonfacility

$409.21

Effective 2026-10-01

The base rate is $59.88 higher than on 2025-10-01, moving from $349.33 to $409.21 (17.1%).

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

    $349.33changed to$409.21

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.83 changed to 3.73
    • Practice expense RVU 6.18 changed to 7.62
    • Malpractice RVU 0.76 changed to 0.83
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $355.13changed to$349.33

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.05 changed to 6.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $349.34changed to$355.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $356.33changed to$349.34

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.90 changed to 6.05
    • Malpractice RVU 0.75 changed to 0.76
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $355.14changed to$356.33

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $353.82changed to$355.14

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.60 changed to 5.90
    • Malpractice RVU 0.76 changed to 0.75
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $348.33changed to$353.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.38 changed to 5.60
    • Malpractice RVU 0.74 changed to 0.76

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $345.78changed to$348.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.99 changed to 5.38
    • Malpractice RVU 0.73 changed to 0.74
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $339.10changed to$345.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.98 changed to 4.99
    • Malpractice RVU 0.57 changed to 0.73
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $334.38changed to$339.10

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.86 changed to 4.98

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $297.36changed to$334.38

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.77 changed to 4.86
    • Malpractice RVU 0.58 changed to 0.57
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $262.86changed to$297.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.74 changed to 4.77
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $263.41changed to$262.86

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.72 changed to 4.74
    • Malpractice RVU 0.59 changed to 0.58

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $262.10changed to$263.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $261.47changed to$262.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.77 changed to 4.72
    • Malpractice RVU 0.62 changed to 0.59
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $257.15changed to$261.47

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.26 changed to 4.77
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $257.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$409.21$350.11RVU26D
2026-07-01$409.21$350.11RVU26C
2026-04-01$409.21$350.11RVU26B
2026-01-01$409.21$350.11RVU26A
2025-10-01$349.33$321.64RVU25D
2025-07-01$349.33$321.64RVU25C
2025-04-01$349.33$321.64RVU25B
2025-01-01$349.33$321.64RVU25A
2024-10-01$355.13$326.98RVU24D
2024-07-01$355.13$326.98RVU24C
2024-04-01$355.13$326.98RVU24B
2024-03-09$355.13$326.98RVU24AR
2024-01-01$349.34$321.64RVU24A
2023-10-01$356.33$327.64RVU23D
2023-07-01$355.14$326.67RVU23C
2023-04-01$355.14$326.67RVU23B
2023-01-01$355.14$326.67RVU23A
2022-10-01$353.82$325.22RVU22D
2022-07-01$353.82$325.22RVU22C
2022-04-01$353.82$325.22RVU22B
2022-01-01$353.82$325.22RVU22A
2021-10-01$348.33$321.24RVU21D
2021-07-01$348.33$321.24RVU21C
2021-04-01$348.33$321.24RVU21B
2021-01-01$348.33$321.24RVU21A
2020-10-01$345.78$320.68RVU20D
2020-07-01$345.78$320.68RVU20C
2020-04-01$345.78$320.68RVU20B
2020-01-01$345.78$320.68RVU20A
2019-10-01$339.10$315.51RVU19D
2019-07-01$339.10$315.51RVU19C
2019-04-01$339.10$315.51RVU19B
2019-01-01$339.10$315.51RVU19A
2018-10-01$334.38$312.62RVU18D
2018-07-01$334.38$312.62RVU18C
2018-04-01$334.38$312.62RVU18B
2018-01-01$334.38$312.62RVU18AR1
2017-10-01$297.36$280.46RVU17D
2017-07-01$297.36$280.46RVU17C
2017-04-01$297.36$280.46RVU17B
2017-01-01$297.36$280.46RVU17A
2016-10-01$262.86$248.98RVU16D
2016-07-01$262.86$248.98RVU16C
2016-04-01$262.86$248.98RVU16B
2016-01-01$262.86$248.98RVU16A
2015-10-01$263.41$248.97RVU15D
2015-07-01$263.41$248.97RVU15C
2015-04-01$262.10$247.73RVU15B
2015-01-01$262.10$247.73RVU15A
2014-10-01$261.47$247.58RVU14D
2014-07-01$261.47$247.58RVU14C
2014-04-01$261.47$247.58RVU14B
2014-01-01$261.47$247.58RVU14A
2013-10-01$257.15$242.85RVU13D
2013-07-01$257.15$242.85RVU13C
2013-04-01$257.15$242.85RVU13B
2013-01-01$257.15$242.85RVU13AR

Price 26700 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

26700 billing questions

When should 26700 be used instead of 26705?

Use 26700 for closed treatment without manipulation. If the provider manipulates the MCP joint to reduce the dislocation, 26705 is the relevant code.

How many units should be reported?

Report one unit for each MCP joint treated. The documentation should identify each affected joint and the treatment provided.

Can modifier 50 be used for dislocations on both hands?

No. Modifier 50 is inappropriate for this code based on its descriptor and anatomy.

Is routine related postoperative care included?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other same-session procedures handled?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

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 26700PPRRVU2026_Oct_nonQPP.csv, line 2,672 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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