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Billing code 26551: Toe-to-hand transferMedicare rate & RVUs

Microsurgical transfer of a great toe to the hand is reported when reconstructing a missing or severely damaged thumb or finger.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,975.35 for 26551 nationally in a facility.

Medicare rate · 26551

Toe-to-hand transfer

Work RVUs
47.27
Total RVUs
89.08
Global days
090

National rate · 2026

$2,975.35

Facility setting, before claim adjustments.

See every locality for 26551 →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 26551 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 26551 covers

This operation moves a great toe to the hand and reconnects its blood supply using microsurgical techniques. It is commonly performed by a hand or plastic surgeon with microsurgical expertise to reconstruct a thumb or finger after traumatic loss or for a congenital absence. The procedure involves work at both the donor foot and recipient hand, often in a hospital operating room.

Report this code for transfer of the great toe, rather than another toe or only a toe joint. The operative report should identify the donor digit, recipient site, indication, and microsurgical transfer performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; 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 26551 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

26551 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,696.55
Alaska*Unavailable$3,682.16
ArizonaUnavailable$2,893.94
ArkansasUnavailable$2,662.40
AtlantaUnavailable$3,064.84
AustinUnavailable$3,001.48
BakersfieldUnavailable$2,975.12
Baltimore/Surr. CntysUnavailable$3,157.88
BeaumontUnavailable$2,856.08
BrazoriaUnavailable$2,904.23

26551 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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View every state and territory as a table
26551 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 26551 rate is calculated

Each of 26551’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 · 26551

RVUs × geographic indexes × conversion factor

Work47.27

47.27 RVUs× 1.000 GPCI

Practice expense31.71

31.71 RVUs× 1.000 GPCI

Malpractice10.10

10.10 RVUs× 1.000 GPCI

Adjusted RVUs

89.0800

Conversion factor

$33.4009

Medicare rate

$2,975.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 26551

26551 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26551

Toe-to-hand transfer

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)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 · 26551

Toe-to-hand transfer

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

26551 without 50 · national facility

$2,975.35

Toe-to-hand transfer

26551-50 · Bilateral: 150%

$4,463.03

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

26551 compared with similar codes

Compare codes · National

5 codes, side by side

  • 26551

    Toe-to-hand transfer47.27 wRVU

    Not priced

  • 26553

    Toe-hand transfer46.97 wRVU

    Not priced

  • 26554

    Toe-to-hand transfer55.58 wRVU

    Not priced

  • 26556

    Toe joint transfer48.51 wRVU

    Not priced

  • 26550

    Thumb reconstruction21.14 wRVU

    Not priced

How to choose

26553Toe-hand transfer
Choose 26551 for transfer of the great toe; 26553 describes transfer of a single other toe to the hand.
26554Toe-to-hand transfer
26554 describes a double toe-to-hand transfer, while 26551 is for transfer of the great toe.
26556Toe joint transfer
26556 is for transfer of a toe joint to the hand; 26551 describes transfer of the great toe.
26550Thumb reconstruction
26550 reconstructs a thumb by repositioning a digit from the hand. Code 26551 transfers the great toe to the hand.

Codes related to 26551

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

Codes related to 26551
CodeHow it relatesNational office range
Same family
26553Toe-hand transferToe-to-hand transfer involving a single toe other than the great toe.No office rate
26554Toe-to-hand transferToe-to-hand transfer involving two toes.No office rate
26556Toe joint transferTransfers a toe joint to the hand rather than the great toe.No office rate
Used instead
26550Thumb reconstructionPollicization uses a hand digit to create a thumb rather than transferring a toe.No office rate

26551 billing questions

When should 26551 be selected instead of 26553?

Use 26551 when the transferred digit is the great toe. Code 26553 describes transfer of a single toe other than the great toe.

How does 26551 differ from 26556?

26551 describes transfer of the great toe to the hand. Code 26556 is for transfer of a toe joint rather than the great toe.

Does the 90-day global period include postoperative care?

Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.

How is bilateral performance paid?

When performed bilaterally and reported with modifier 50, CMS pays at 150%.

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 26551PPRRVU2026_Oct_nonQPP.csv, line 2,641 (RVU26D)

Open CMS sourceHow we calculate rates

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