FeeBase
Log inGet started
Menu

Billing code 26542: Joint ligament repairMedicare rate & RVUs

Reports repair of a hand joint collateral ligament using a tendon graft when the surgeon restores stability at a metacarpophalangeal or interphalangeal joint.

CMS RVU26DEffective Oct 1, 2026109 payment localities248 Medicare services in 2024

Medicare pays $696.74 for 26542 nationally in a facility.

Medicare rate · 26542

Joint ligament repair

Swap in your local Medicare rate.

Work RVUs
6.78
Total RVUs
20.86
Global days
090

National rate · 2026

$696.74

Facility setting, before claim adjustments.

See every locality for 26542 → · 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 26542 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 26542 covers

The surgeon repairs a deficient collateral ligament at a metacarpophalangeal or interphalangeal joint using a tendon graft. This may be needed for chronic instability or a ligament injury that cannot be adequately repaired with the patient’s existing tissue. Hand surgeons typically perform the operation in a hospital outpatient department or ambulatory surgery center; a tendon graft may be harvested as part of the procedure.

Report the code when the operative work includes ligament repair with a tendon graft, rather than direct repair or augmentation using local tissue. The operative report should identify the joint, ligament, instability or injury, graft, and repair technique. CMS assigns 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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 26542 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

26542 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$624.54
Alaska*Unavailable$818.22
ArizonaUnavailable$677.26
ArkansasUnavailable$615.50
AtlantaUnavailable$712.98
AustinUnavailable$717.00
BakersfieldUnavailable$725.05
Baltimore/Surr. CntysUnavailable$741.82
BeaumontUnavailable$655.24
BrazoriaUnavailable$685.16

26542 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
26542 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 26542 rate is calculated

Each of 26542’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 · 26542

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.78Practice expense 12.78Malpractice 1.30

20.8600 adjusted RVUs×$33.4009 conversion factor=$696.74

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

Payment rules and modifiers for 26542

26542 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26542

Joint ligament repair

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)0Not paid without supporting documentation.
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 · 26542

Joint ligament repair

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

26542 without 51 · national facility

$696.74

Joint ligament repair

26542-51 · Second procedure: 50%

$348.37

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

26542 compared with similar codes

Compare codes

26542 vs 26540 vs 26541 vs 26545: national Medicare rates

Swap in your local Medicare rate.

  • 26542
    Joint ligament repair · 6.78 wRVU
    —
  • 26540
    Ligament repair · 6.44 wRVU
    —
  • 26541
    Ligament repair · 8.59 wRVU
    —
  • 26545
    Finger joint reconstruction · 6.93 wRVU
    —

How to choose

26540Ligament repair
Choose 26540 for collateral ligament repair without a tendon graft; 26542 captures repair using a tendon graft.
26541Ligament repair
Choose 26541 when local tissue is used for the ligament repair. A tendon graft points to 26542.
26545Finger joint reconstruction
26545 describes collateral ligament reconstruction at the metacarpophalangeal joint with a tendon graft. Distinguish it from 26542 by the procedure performed and the joint involved.

Codes related to 26542

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

Codes related to 26542
CodeHow it relatesNational office range
Same family
26540Ligament repairCollateral ligament repair without the tendon-graft technique.No office rate
26541Ligament repairCollateral ligament repair using local tissue rather than a tendon graft.No office rate
Used instead
26545Finger joint reconstructionCollateral ligament reconstruction at the metacarpophalangeal joint with a tendon graft.No office rate

26542 billing questions

How does this differ from 26540?

Use 26542 when the collateral ligament repair uses a tendon graft. Code 26540 describes collateral ligament repair without that graft technique.

How does this differ from 26541?

Code 26541 is for collateral ligament repair using local tissue. Code 26542 identifies repair with a tendon graft.

What should the operative note document?

Document the affected metacarpophalangeal or interphalangeal joint, the collateral ligament and its deficiency, and the tendon graft repair performed.

Can modifier 50 be used for both hands?

No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy makes modifier 50 unsuitable.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%. Assistant-at-surgery payment requires documented medical necessity.

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 26542PPRRVU2026_Oct_nonQPP.csv, line 2,636 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 26542 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 26542 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 →