Billing code 26341: Cord manipulationMedicare rate & RVUs

Reports manipulation of a Dupuytren palmar cord after enzyme injection to improve contracture in a treated finger.

CMS RVU26DEffective Oct 1, 2026109 payment localities7.8K Medicare services in 2024

Medicare pays $124.25 for 26341 nationally in the office and $73.15 in a hospital or facility. Local office rates run $108.97–$164.16.

Medicare rate · 26341

Cord manipulation

Swap in your local Medicare rate.

Work RVUs
0.89
Total RVUs
3.72
Global days
010

National rate · 2026

$124.25

Office setting, before claim adjustments.

See every locality for 26341 → · 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 26341 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 26341 covers

A hand surgeon or other qualified physician manipulates the treated finger and palmar tissue to disrupt a Dupuytren cord after an enzyme injection, such as collagenase. The service is directed at the contracture caused by the injected cord, rather than a stiff finger joint unrelated to enzyme treatment. It is commonly performed in an office or other procedural setting as the follow-up treatment to the injection.

Report this code for one treated digit in a hand; manipulation may address multiple cords in that hand. Documentation should identify the treated hand and digit, the prior enzyme injection, and the manipulation performed. The related postoperative visits are included for 10 days. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 26341 pays more and less

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

109 payment localities

$108.97 to $164.16

$108.97$136.56$164.16
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

26341 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$110.68$65.97
Alaska*$142.34$87.92
Arizona$120.68$71.16
Arkansas$108.97$65.07
Atlanta$126.90$74.98
Austin$128.82$74.75
Bakersfield$131.13$75.12
Baltimore/Surr. Cntys$132.56$77.72
Beaumont$115.85$69.35
Brazoria$122.44$71.80

26341 rates by state

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

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.

$108.97

$147.41

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

View every state and territory as a table
26341 office rate range by state
State / territoryOffice rate rangeLocalities
AK$142.341
AL$110.681
AR$108.971
AZ$120.681
CA$130.65–$164.1629
CO$129.051
CT$132.881
DC$142.311
DE$122.761
FL$123.20–$136.583
GA$115.75–$126.902
GU$134.031
HI$134.031
IA$113.281
ID$114.151
IL$119.72–$132.264
IN$114.851
KS$112.911
KY$113.911
LA$113.80–$119.782
MA$128.28–$142.082
MD$125.15–$142.313
ME$115.00–$121.362
MI$117.25–$125.042
MN$122.831
MO$111.84–$120.003
MS$110.421
MT$124.241
NC$116.251
ND$120.881
NE$113.881
NH$127.181
NJ$134.17–$140.732
NM$118.021
NV$123.391
NY$118.12–$147.815
OH$116.571
OK$113.481
OR$122.21–$133.142
PA$116.65–$129.532
PR$125.141
RI$127.131
SC$116.651
SD$120.481
TN$113.541
TX$115.85–$128.828
UT$118.341
VA$121.07–$142.312
VI$125.141
VT$120.561
WA$127.99–$144.872
WI$116.591
WV$115.061
WY$122.781

How the 26341 rate is calculated

Each of 26341’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 · 26341

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.89Practice expense 2.66Malpractice 0.17

3.7200 adjusted RVUs×$33.4009 conversion factor=$124.25

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

Payment rules and modifiers for 26341

26341 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26341

Cord manipulation

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 26341

Cord manipulation

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

26341 without 50 · national office

$124.25

Cord manipulation

26341-50 · Bilateral: 150%

$186.38

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

26341 compared with similar codes

Compare codes

26341 vs 20527 vs 26340 vs 26123: national Medicare rates

Swap in your local Medicare rate.

  • 26341
    Cord manipulation · 0.89 wRVU
    $124.25
  • 20527
    Palmar cord injection · 0.98 wRVU
    $94.19−$30.06
  • 26340
    Finger manipulation · 2.73 wRVU
    —
  • 26123
    Dupuytren release · 10.61 wRVU
    —

How to choose

20527Palmar cord injection
20527 represents injection of an enzyme into a Dupuytren cord. Code 26341 represents the later manipulation of the treated cord.
26340Finger manipulation
26340 applies to manipulation of a finger joint under anesthesia. Choose 26341 when the target is a palmar cord after enzyme injection.
26123Dupuytren release
26123 describes surgical removal or release of palmar fascia for Dupuytren contracture; 26341 describes manipulation after enzyme treatment.

26341 billing questions

How does this differ from 26340?

Use 26341 for manipulation of a palmar Dupuytren cord after enzyme injection. Code 26340 describes manipulation of a finger joint under anesthesia, not post-injection cord disruption.

Is the enzyme injection included?

No. Code 26341 represents the subsequent manipulation; report the injection separately with 20527 when performed and otherwise reportable.

What documentation supports the code?

Document the enzyme-treated Dupuytren cord, the hand and digit treated, and the manipulation performed. Identify multiple cords if they were addressed in the same hand.

How is bilateral treatment handled?

For treatment of both hands, CMS pays modifier 50 at 150%. The service is described per hand, for a single digit, including multiple cords.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and other procedures at 50%. Related postoperative visits are included during the 10-day global period.

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 26341PPRRVU2026_Oct_nonQPP.csv, line 2,574 (RVU26D)

Open CMS sourceHow we calculate rates

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