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Billing code 26045: Palmar releaseMedicare rate & RVUs

Reports open division of a contracted palmar fascial cord, typically for Dupuytren disease causing restricted finger extension.

CMS RVU26DEffective Oct 1, 2026109 payment localities913 Medicare services in 2024

Medicare pays $453.25 for 26045 nationally in a facility.

Medicare rate · 26045

Palmar release

Swap in your local Medicare rate.

Work RVUs
5.59
Total RVUs
13.57
Global days
090

National rate · 2026

$453.25

Facility setting, before claim adjustments.

See every locality for 26045 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 26045 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 26045 covers

billing code 26045 represents an open palmar fasciotomy: the surgeon makes an incision over a contracted palmar fascial cord and divides it to release the contracture. The procedure is commonly performed for Dupuytren disease when a fixed contracture limits hand or finger extension. Hand, orthopedic, and plastic surgeons may perform it in an operating room or another surgical setting.

Choose this code when the documented work is open division of the contracted fascia, rather than percutaneous release or excision of diseased fascia. The operative note should identify the treated palm, the contracture and cord released, and the open technique. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of 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%. Medicare does not pay an assistant at surgery; 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 26045 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

26045 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$408.48
Alaska*Unavailable$544.87
ArizonaUnavailable$440.80
ArkansasUnavailable$402.91
AtlantaUnavailable$464.93
AustinUnavailable$462.71
BakersfieldUnavailable$464.33
Baltimore/Surr. CntysUnavailable$481.78
BeaumontUnavailable$429.97
BrazoriaUnavailable$444.52

26045 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
26045 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 26045 rate is calculated

Each of 26045’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 · 26045

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.59Practice expense 6.87Malpractice 1.11

13.5700 adjusted RVUs×$33.4009 conversion factor=$453.25

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 26045

26045 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26045

Palmar release

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 26045

Palmar release

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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 50 · payment effect

With and without the modifier

26045 without 50 · national facility

$453.25

Palmar release

26045-50 · Bilateral: 150%

$679.88

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).

When to use modifier 50

26045 compared with similar codes

Compare codes

26045 vs 26040 vs 26121 vs 26123: national Medicare rates

Swap in your local Medicare rate.

  • 26045
    Palmar release · 5.59 wRVU
    —
  • 26040
    Palm contracture release · 3.37 wRVU
    —
  • 26121
    Palmar fasciectomy · 7.54 wRVU
    —
  • 26123
    Dupuytren release · 10.61 wRVU
    —

How to choose

26040Palm contracture release
26040 is a percutaneous palmar release; 26045 is the open release. Select based on the operative approach documented.
26121Palmar fasciectomy
26121 describes excision of palmar fascia. 26045 describes open division of contracted fascia without fasciectomy.
26123Dupuytren release
26123 describes palmar fasciectomy with release extending into a digit, including the PIP joint. 26045 is an open palmar fasciotomy.

Codes related to 26045

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

Codes related to 26045
CodeHow it relatesNational office range
Used instead
26040Palm contracture releasePercutaneous palmar release for a contracture treated without the open approach.No office rate
26121Palmar fasciectomyPalmar fasciectomy when contracted fascia is excised rather than divided.No office rate
26123Dupuytren releaseFasciectomy with release of a digit when the operative work extends into the digit.No office rate

26045 billing questions

How does 26045 differ from 26040?

26045 describes open division of the palmar fascia. 26040 is used for percutaneous palmar release.

When is a fasciectomy code more appropriate?

Use a fasciectomy code when the surgeon removes diseased palmar fascia rather than simply dividing the contracted cord. The operative report should support the work performed.

Does the 90-day global include postoperative visits?

Related postoperative care for 90 days is included, as is the day-before preoperative visit.

How is bilateral 26045 reported?

Report bilateral treatment with modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

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

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 26045PPRRVU2026_Oct_nonQPP.csv, line 2,536 (RVU26D)

Open CMS sourceHow we calculate rates

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