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Billing code 26530: Knuckle arthroplastyMedicare rate & RVUs

Report this procedure for arthroplasty of a metacarpophalangeal joint when the surgeon reshapes or removes damaged joint surfaces without prosthetic replacement.

CMS RVU26DEffective Oct 1, 2026109 payment localities428 Medicare services in 2024

Medicare pays $509.70 for 26530 nationally in a facility.

Medicare rate · 26530

Knuckle arthroplasty

Swap in your local Medicare rate.

Work RVUs
6.71
Total RVUs
15.26
Global days
090

National rate · 2026

$509.70

Facility setting, before claim adjustments.

See every locality for 26530 → · 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 26530 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 26530 covers

This code covers arthroplasty of a metacarpophalangeal (MCP) joint, the knuckle connecting a finger or thumb to the hand. A hand surgeon may reshape or remove damaged joint surfaces and address the joint’s alignment or motion. Typical clinical situations include painful arthritis or joint deformity affecting MCP function. The prosthetic-replacement version is a separate code, so the operative report should make clear whether an implant was used.

Report the service for each MCP joint treated, supported by documentation of the specific joint, the indication, and the work performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare may pay for 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 26530 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

26530 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$460.79
Alaska*Unavailable$618.35
ArizonaUnavailable$496.01
ArkansasUnavailable$454.72
AtlantaUnavailable$522.85
AustinUnavailable$519.36
BakersfieldUnavailable$520.55
Baltimore/Surr. CntysUnavailable$541.14
BeaumontUnavailable$484.81
BrazoriaUnavailable$499.90

26530 rates by state

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

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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
26530 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 26530 rate is calculated

Each of 26530’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 · 26530

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.71Practice expense 7.27Malpractice 1.28

15.2600 adjusted RVUs×$33.4009 conversion factor=$509.70

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

Payment rules and modifiers for 26530

26530 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26530

Knuckle arthroplasty

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
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 · 26530

Knuckle arthroplasty

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 51 · payment effect

With and without the modifier

26530 without 51 · national facility

$509.70

Knuckle arthroplasty

26530-51 · Second procedure: 50%

$254.85

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%).

When to use modifier 51

26530 compared with similar codes

Compare codes

26530 vs 26531 vs 26535 vs 26520: national Medicare rates

Swap in your local Medicare rate.

  • 26530
    Knuckle arthroplasty · 6.71 wRVU
    —
  • 26531
    Knuckle arthroplasty · 7.93 wRVU
    —
  • 26535
    Finger joint surgery · 5.27 wRVU
    —
  • 26520
    Knuckle release · 5.33 wRVU
    —

How to choose

26531Knuckle arthroplasty
Both address MCP joint arthroplasty, but 26531 is for prosthetic replacement. Use 26530 when the procedure does not include a prosthetic replacement.
26535Finger joint surgery
This code is for arthroplasty of an interphalangeal joint, between finger bones. Code 26530 is for the MCP knuckle joint.
26520Knuckle release
This code describes release of an MCP contracture. It is not a substitute for arthroplasty when the surgeon operates on the joint surfaces.

Codes related to 26530

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

Codes related to 26530
CodeHow it relatesNational office range
Same family
26531Knuckle arthroplastyMCP joint arthroplasty when a prosthetic replacement is used.No office rate
Used instead
26535Finger joint surgeryArthroplasty of an interphalangeal joint rather than an MCP joint.No office rate
26516Knuckle fusionMCP joint fusion rather than arthroplasty.No office rate
26520Knuckle releaseRelease of an MCP contracture rather than joint arthroplasty.No office rate

26530 billing questions

When should 26530 be reported instead of 26531?

Use 26530 for MCP joint arthroplasty without prosthetic replacement. When the surgeon uses a prosthetic replacement, the related code is 26531.

How is the number of services determined?

The code is reported for each MCP joint treated. The operative report should identify the specific joint or joints and the procedure performed.

Can modifier 50 be used when both hands are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Document the joints treated and follow applicable claim reporting instructions for the number of services.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant surgeon be paid for this procedure?

CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.

How does the multiple-procedure rule affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

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 26530PPRRVU2026_Oct_nonQPP.csv, line 2,630 (RVU26D)

Open CMS sourceHow we calculate rates

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