No office rate
26540 describes direct collateral ligament repair. Report 26545 when the surgeon reconstructs the ligament using graft tissue.
On this page
CMS RVU26D · Effective 2026-10-01
26545 Finger joint reconstruction Medicare reimbursement rates
Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability. Compare 26545 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26545?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$625.27–$903.63
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $278.36 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 26545 pays more and less
Hand surgery
About 26545: Finger joint ligament reconstruction with graft
Reconstructs a finger joint’s stabilizing ligament with graft tissue when damaged ligament cannot provide adequate support, such as in persistent joint instability.
The surgeon reconstructs a stabilizing ligament at a finger joint using graft tissue when the existing ligament is deficient or unsuitable for a straightforward repair. This may be considered for persistent instability after an injury, including cases in which damaged ligament tissue cannot hold a direct repair. A hand or orthopedic surgeon typically performs the procedure in an operating room, with the operative report identifying the joint, the ligament addressed, and the graft used or obtained.
Report this service when the operative work supports ligament reconstruction with graft, rather than direct ligament repair or a joint replacement or fusion. Documentation should describe the instability or ligament deficiency, the reconstruction performed, and the graft. CMS classifies the procedure as major surgery with 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 others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26545
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.93 · 33%
- Practice expense (office) RVU12.94 · 61%
- Malpractice RVU1.31 · 6%
118
Medicare services in 2024 · #4751 by national volume
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.
26545 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
26541 is a ligament repair involving a tendon graft; distinguish it from the reconstruction performed for this code by the operative technique documented.
No office rate
26530 is arthroplasty of a metacarpophalangeal joint. It addresses the joint with an arthroplasty procedure, not ligament reconstruction.
See how rates vary across the country
26545 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 26545 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $634.42 |
| Alaska* | Office Unavailable | Facility $831.61 |
| Arizona | Office Unavailable | Facility $687.73 |
| Arkansas | Office Unavailable | Facility $625.27 |
| Atlanta | Office Unavailable | Facility $723.84 |
| Austin | Office Unavailable | Facility $727.97 |
| Bakersfield | Office Unavailable | Facility $736.21 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $753.06 |
| Beaumont | Office Unavailable | Facility $665.43 |
| Brazoria | Office Unavailable | Facility $695.77 |
| Chicago | Office Unavailable | Facility $767.88 |
| Chico | Office Unavailable | Facility $732.56 |
| Colorado | Office Unavailable | Facility $728.29 |
| Connecticut | Office Unavailable | Facility $754.53 |
| Dallas | Office Unavailable | Facility $701.57 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $801.81 |
| Delaware | Office Unavailable | Facility $698.98 |
| Detroit | Office Unavailable | Facility $722.32 |
| East St. Louis | Office Unavailable | Facility $717.22 |
| El Centro | Office Unavailable | Facility $732.77 |
| Fort Lauderdale | Office Unavailable | Facility $748.40 |
| Fort Worth | Office Unavailable | Facility $697.82 |
| Fresno | Office Unavailable | Facility $732.56 |
| Galveston | Office Unavailable | Facility $698.73 |
| Hanford-Corcoran | Office Unavailable | Facility $732.56 |
| Hawaii, Guam | Office Unavailable | Facility $748.22 |
| Houston | Office Unavailable | Facility $722.71 |
| Idaho | Office Unavailable | Facility $649.80 |
| Indiana | Office Unavailable | Facility $653.39 |
| Iowa | Office Unavailable | Facility $644.31 |
| Kansas | Office Unavailable | Facility $644.24 |
| Kentucky | Office Unavailable | Facility $655.74 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $781.31 |
| Madera | Office Unavailable | Facility $732.56 |
| Manhattan | Office Unavailable | Facility $817.90 |
| Merced | Office Unavailable | Facility $732.56 |
| Metropolitan Boston | Office Unavailable | Facility $795.96 |
| Metropolitan Kansas City | Office Unavailable | Facility $680.06 |
| Metropolitan Philadelphia | Office Unavailable | Facility $737.76 |
| Metropolitan St. Louis | Office Unavailable | Facility $686.77 |
| Miami | Office Unavailable | Facility $792.05 |
| Minnesota | Office Unavailable | Facility $689.16 |
| Mississippi | Office Unavailable | Facility $635.93 |
| Modesto | Office Unavailable | Facility $732.56 |
| Montana** | Office Unavailable | Facility $707.34 |
| Napa | Office Unavailable | Facility $837.93 |
| Nebraska | Office Unavailable | Facility $646.94 |
| Nevada** | Office Unavailable | Facility $700.56 |
| New Hampshire | Office Unavailable | Facility $719.68 |
| New Mexico | Office Unavailable | Facility $680.35 |
| New Orleans | Office Unavailable | Facility $687.88 |
| North Carolina | Office Unavailable | Facility $662.68 |
| North Dakota** | Office Unavailable | Facility $681.44 |
| Northern Nj | Office Unavailable | Facility $794.14 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $841.43 |
| Ohio | Office Unavailable | Facility $670.18 |
| Oklahoma | Office Unavailable | Facility $651.43 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $776.08 |
| Portland | Office Unavailable | Facility $747.91 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $768.10 |
| Puerto Rico | Office Unavailable | Facility $711.53 |
| Queens | Office Unavailable | Facility $820.25 |
| Redding | Office Unavailable | Facility $732.56 |
| Rest Of California | Office Unavailable | Facility $732.56 |
| Rest Of Florida | Office Unavailable | Facility $710.42 |
| Rest Of Georgia | Office Unavailable | Facility $669.15 |
| Rest Of Illinois | Office Unavailable | Facility $694.46 |
| Rest Of Louisiana | Office Unavailable | Facility $655.89 |
| Rest Of Maine | Office Unavailable | Facility $656.31 |
| Rest Of Maryland | Office Unavailable | Facility $711.34 |
| Rest Of Massachusetts | Office Unavailable | Facility $725.16 |
| Rest Of Michigan | Office Unavailable | Facility $675.47 |
| Rest Of Missouri | Office Unavailable | Facility $646.65 |
| Rest Of New Jersey | Office Unavailable | Facility $760.70 |
| Rest Of New York | Office Unavailable | Facility $672.83 |
| Rest Of Oregon | Office Unavailable | Facility $692.71 |
| Rest Of Pennsylvania | Office Unavailable | Facility $669.58 |
| Rest Of Texas | Office Unavailable | Facility $681.14 |
| Rest Of Washington | Office Unavailable | Facility $722.89 |
| Rhode Island | Office Unavailable | Facility $721.37 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $746.66 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $765.91 |
| Salinas | Office Unavailable | Facility $763.03 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $779.05 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $882.95 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $881.47 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $903.63 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $897.54 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $751.14 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $784.91 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $765.36 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $792.62 |
| Seattle (King Cnty) | Office Unavailable | Facility $809.11 |
| South Carolina | Office Unavailable | Facility $668.02 |
| South Dakota** | Office Unavailable | Facility $678.38 |
| Southern Maine | Office Unavailable | Facility $687.40 |
| Stockton | Office Unavailable | Facility $732.56 |
| Suburban Chicago | Office Unavailable | Facility $754.50 |
| Tennessee | Office Unavailable | Facility $647.84 |
| Utah | Office Unavailable | Facility $677.04 |
| Vallejo | Office Unavailable | Facility $835.78 |
| Vermont | Office Unavailable | Facility $681.49 |
| Virgin Islands | Office Unavailable | Facility $711.53 |
| Virginia | Office Unavailable | Facility $687.22 |
| Visalia | Office Unavailable | Facility $732.56 |
| West Virginia | Office Unavailable | Facility $669.67 |
| Wisconsin | Office Unavailable | Facility $659.00 |
| Wyoming** | Office Unavailable | Facility $696.05 |
| Yuba City | Office Unavailable | Facility $732.56 |
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26545 billing questions
How is this different from a direct ligament repair?
Use this code when the surgeon reconstructs the ligament with graft tissue. A direct repair of the existing ligament is a different service.
Does the code include obtaining the graft?
The operative documentation should identify the graft and the reconstruction performed. Check the applicable CPT descriptor and coding guidance before separately reporting graft procurement.
Can modifier 50 be used for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not apply.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant-at-surgery be paid?
CMS payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,63426540,,Repair hand joint,A,,6.44,12.66,NA,12.66,,1.24,20.34,20.34,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63526541,,Repair hand joint with graft,A,,8.59,13.70,NA,13.70,,1.65,23.94,23.94,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63626542,,Repair hand joint with graft,A,,6.78,12.78,NA,12.78,,1.30,20.86,20.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63726545,,Reconstruct finger joint,A,,6.93,12.94,NA,12.94,,1.31,21.18,21.18,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63826546,,Repair nonunion hand,A,,10.56,17.16,NA,17.16,,2.02,29.74,29.74,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,63926548,,Reconstruct finger joint,A,,8.01,13.39,NA,13.39,,1.53,22.93,22.93,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,64026550,,Pollicization digit,A,,21.14,20.42,NA,20.42,,4.50,46.06,46.06,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00