CPT code 26842: Thumb fusion, carpometacarpal joint, with graft2026 Medicare rate & RVUs in Texas
Reports fusion of the thumb’s carpometacarpal joint using autogenous bone graft, commonly for painful arthritis, instability, or post-traumatic joint damage.
CMS doesn’t publish an office rate for 26842 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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What 26842 covers
This operation fuses the carpometacarpal joint at the base of the thumb using the patient’s own bone graft. The surgeon prepares the joint surfaces, places graft to support fusion, and may use internal fixation to hold the bones in position. Hand or orthopedic surgeons commonly perform it in an operating room for symptomatic basal-joint arthritis, instability, or damage after trauma when fusion is selected. The graft-harvesting work is included in the service; document its source and use as part of the operative record.
Report this code when the operative documentation supports fusion of the thumb carpometacarpal joint with autogenous graft, rather than fusion of another thumb or hand joint or fusion without graft. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 26842 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 | $837.71 |
| Beaumont, TX | Unavailable | $768.55 |
| Brazoria, TX | Unavailable | $800.94 |
| Dallas, TX | Unavailable | $808.20 |
| Fort Worth, TX | Unavailable | $804.16 |
| Galveston, TX | Unavailable | $804.72 |
| Houston, TX | Unavailable | $836.94 |
| Rest of Texas | Unavailable | $785.77 |
How the 26842 rate is calculated
Each of 26842’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 · 26842
RVUs × geographic indexes × conversion factor
Work8.28
8.28 RVUs× 1.000 GPCI
Practice expense14.39
14.39 RVUs× 1.000 GPCI
Malpractice1.76
1.76 RVUs× 1.000 GPCI
Adjusted RVUs
24.4300
Conversion factor
$33.4009
Medicare rate
$815.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26842
26842 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26842
Thumb fusion, carpometacarpal joint, with graft
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 26842
Thumb fusion, carpometacarpal joint, with graft
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 50 · payment effect
With and without the modifier
26842 without 50 · national facility
$815.98
Thumb fusion, carpometacarpal joint, with graft
26842-50 · Bilateral: 150%
$1,223.97
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
26842 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 26841Thumb fusionCarpometacarpal joint
- Both describe thumb carpometacarpal fusion; choose 26842 when autogenous bone graft is used and 26841 when it is not.
- 26844Hand joint fusionNonthumb CMC with autograft
- This code is for a grafted carpometacarpal fusion of a hand joint other than the thumb. Use 26842 when the fused joint is the thumb carpometacarpal joint.
- 26852Knuckle fusionWith fixation and graft
- This code is for grafted metacarpophalangeal joint fusion. Code 26842 is for the thumb carpometacarpal joint.
26842 billing questions
How does this differ from 26841?
Use 26842 when the thumb carpometacarpal fusion includes autogenous bone graft. Code 26841 describes the corresponding fusion without graft.
Can the bone-graft harvest be billed separately?
The graft-obtaining work is included in this service. Document the graft source and its use in the fusion.
Which joint must be fused for this code?
The procedure must fuse the carpometacarpal joint at the base of the thumb. A fusion of a finger joint or another hand joint is not this service.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays this code at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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
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