FeeBase
Log inGet started
Menu

Billing code 26518: Knuckle fusionMedicare rate & RVUs

Surgical fusion of multiple finger knuckle joints, reported when the operative plan permanently joins the joints rather than releasing or reconstructing them.

CMS RVU26DEffective Oct 1, 2026109 payment localities30 Medicare services in 2024

Medicare pays $855.06 for 26518 nationally in a facility.

Medicare rate · 26518

Knuckle fusion

Swap in your local Medicare rate.

Work RVUs
9.04
Total RVUs
25.60
Global days
090

National rate · 2026

$855.06

Facility setting, before claim adjustments.

See every locality for 26518 → · 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 26518 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 26518 covers

A hand surgeon prepares the involved finger knuckle joints and holds the joint surfaces together so they can fuse in a planned position. The operation may address painful deformity, instability, or joint damage when preserving motion is not the goal. It is generally performed in an operating room, with the operative report identifying each joint treated and the fixation or other techniques used.

Report this code for the multiple-joint fusion service it represents, using the operative documentation to support the joints fused and the work performed. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 26518 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

26518 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$766.11
Alaska*Unavailable$1,009.03
ArizonaUnavailable$830.67
ArkansasUnavailable$755.01
AtlantaUnavailable$876.68
AustinUnavailable$876.72
BakersfieldUnavailable$882.67
Baltimore/Surr. CntysUnavailable$910.79
BeaumontUnavailable$806.50
BrazoriaUnavailable$838.97

26518 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.

View every state and territory as a table
26518 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 26518 rate is calculated

Each of 26518’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 · 26518

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.04Practice expense 14.64Malpractice 1.92

25.6000 adjusted RVUs×$33.4009 conversion factor=$855.06

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

Payment rules and modifiers for 26518

26518 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26518

Knuckle fusion

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 26518

Knuckle fusion

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

26518 without 50 · national facility

$855.06

Knuckle fusion

26518-50 · Bilateral: 150%

$1,282.59

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

26518 compared with similar codes

Compare codes

26518 vs 26516 vs 26520 vs 26530: national Medicare rates

Swap in your local Medicare rate.

  • 26518
    Knuckle fusion · 9.04 wRVU
    —
  • 26516
    Knuckle fusion · 7.14 wRVU
    —
  • 26520
    Knuckle release · 5.33 wRVU
    —
  • 26530
    Knuckle arthroplasty · 6.71 wRVU
    —

How to choose

26516Knuckle fusion
Both describe knuckle-joint fusion services. Use the code whose billing code descriptor matches the specific joints and extent documented in the operative report.
26520Knuckle release
This code addresses fusion; 26520 releases a knuckle-joint contracture without making fusion the operative goal.
26530Knuckle arthroplasty
Fusion permanently joins the joint, while 26530 describes knuckle-joint revision intended to address the joint without the same fusion service.

Codes related to 26518

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

Codes related to 26518
CodeHow it relatesNational office range
Same family
26516Knuckle fusionRelated knuckle-joint fusion code; distinguish the service by the operative details and applicable descriptor.No office rate
26517Knuckle fusionNeighboring fusion code for a related knuckle-joint service; verify the documented joint and procedure.No office rate
Used instead
26520Knuckle releaseReleases a knuckle-joint contracture rather than permanently fusing the joint.No office rate
26530Knuckle arthroplastyRevises a knuckle joint to preserve or restore joint function rather than fuse it.No office rate

26518 billing questions

How is this different from 26516?

Both codes concern fusion of knuckle joints, but the code choice depends on the specific service represented by the operative report. Confirm the joint sites and extent of fusion against the applicable billing code descriptor rather than choosing by the general term “knuckle.”

Is routine postoperative care separately reported?

The 90-day global period includes related postoperative care and the preoperative visit on the day before surgery. Separately report only services that are distinct from the included global care and meet applicable coding requirements.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction, with payment at 50%.

Can modifier 50 be used when both hands are treated?

CMS identifies this as a bilateral procedure. When performed bilaterally and reported with modifier 50, payment is at 150%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with 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
RVUs for 26518PPRRVU2026_Oct_nonQPP.csv, line 2,627 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26518 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 26518 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →