CPT code 26852: Knuckle fusion, with fixation and graft2026 Medicare rate & RVUs in Illinois
Reports fusion of a finger’s metacarpophalangeal joint using internal fixation and bone graft, such as for painful arthritis or joint instability.
CMS doesn’t publish an office rate for 26852 in Illinois.
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 26852 covers
This service fuses a metacarpophalangeal (MCP) joint—the knuckle where a finger meets the hand—using internal fixation and bone graft. A hand or orthopedic surgeon may perform it for a painful, unstable, or severely damaged joint, including after trauma or when arthritis has made motion unreliable. The code’s graft component includes obtaining the autograft. It is for an MCP joint, not a thumb carpometacarpal joint or a finger interphalangeal joint.
Report the code for the MCP fusion with fixation and graft, identifying the digit and documenting the condition, operative work, fixation, and graft use. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 26852 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $869.19 |
| East St. Louis, IL | Unavailable | $813.17 |
| Rest of Illinois | Unavailable | $785.71 |
| Suburban Chicago, IL | Unavailable | $851.14 |
How the 26852 rate is calculated
Each of 26852’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 · 26852
RVUs × geographic indexes × conversion factor
Work8.49
8.49 RVUs× 1.000 GPCI
Practice expense13.71
13.71 RVUs× 1.000 GPCI
Malpractice1.61
1.61 RVUs× 1.000 GPCI
Adjusted RVUs
23.8100
Conversion factor
$33.4009
Medicare rate
$795.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 26852
26852 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26852
Knuckle fusion, with fixation and 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 26852
Knuckle fusion, with fixation and 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 51 · payment effect
With and without the modifier
26852 without 51 · national facility
$795.28
Knuckle fusion, with fixation and graft
26852-51 · Second procedure: 50%
$397.64
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%).
26852 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 26850Knuckle fusionMetacarpophalangeal joint
- Both address an MCP joint. Choose 26852 when the fusion uses internal fixation and bone graft; 26850 describes MCP fusion without internal fixation.
- 26860Finger joint fusionOne interphalangeal joint
- 26860 is for a finger interphalangeal joint, such as a joint within the finger. 26852 is for the MCP knuckle where the finger meets the hand.
- 26862Finger fusionInterphalangeal joint with graft
- 26862 describes graft-assisted fusion at a finger interphalangeal joint. Use 26852 when the fused joint is the MCP joint.
- 26844Hand joint fusionNonthumb CMC with autograft
- 26844 is for graft-assisted fusion of a non-thumb carpometacarpal joint. 26852 is for fusion of a finger MCP joint.
26852 billing questions
How does 26852 differ from 26850?
26852 describes MCP fusion using internal fixation and bone graft. 26850 is the related MCP fusion code without internal fixation.
Can the bone-graft harvest be billed separately?
The graft component of 26852 includes obtaining the autograft. Do not report a separate harvest charge for that included work.
Which joint does 26852 cover?
It covers a finger metacarpophalangeal joint at the knuckle. A thumb carpometacarpal fusion or a finger interphalangeal fusion is coded from a different part of the arthrodesis family.
What documentation supports reporting 26852?
The operative report should identify the digit and MCP joint, the fusion performed, use of internal fixation, and the bone graft. Document the clinical reason for fusion, such as joint pain or instability.
Should modifier 50 be used for bilateral MCP fusions?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the applicable coding instructions for each procedure performed.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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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