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Billing code 26553: Toe-hand transferMedicare rate & RVUs

Reports microsurgical transfer of one toe to the hand to reconstruct a missing or severely deficient digit, with the great-toe-specific and double-transfer services coded separately.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,954.98 for 26553 nationally in a facility.

Medicare rate · 26553

Toe-hand transfer

Work RVUs
46.97
Total RVUs
88.47
Global days
090

National rate · 2026

$2,954.98

Facility setting, before claim adjustments.

See every locality for 26553 →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 26553 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 26553 covers

This operation moves one toe, along with the tissues needed for reconstruction, to the hand and reconnects its blood supply using microsurgical techniques. Hand surgeons and reconstructive microsurgeons perform it to restore useful digit length, opposition, or grasp after traumatic loss or for a congenital hand deficiency. The operation involves coordinated treatment of the donor foot and recipient hand, typically in an operating room.

Select this code for a single toe transfer; use the great-toe-specific code when that service applies and the double-transfer code when two toes are transferred. The operative report should identify the number and source of transferred toes, the recipient-hand reconstruction, and the microsurgical work. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 26553 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

26553 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,677.99
Alaska*Unavailable$3,656.96
ArizonaUnavailable$2,874.08
ArkansasUnavailable$2,644.06
AtlantaUnavailable$3,043.96
AustinUnavailable$2,980.77
BakersfieldUnavailable$2,954.38
Baltimore/Surr. CntysUnavailable$3,136.32
BeaumontUnavailable$2,836.60
BrazoriaUnavailable$2,884.22

26553 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
26553 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 26553 rate is calculated

Each of 26553’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 · 26553

RVUs × geographic indexes × conversion factor

Work46.97

46.97 RVUs× 1.000 GPCI

Practice expense31.45

31.45 RVUs× 1.000 GPCI

Malpractice10.05

10.05 RVUs× 1.000 GPCI

Adjusted RVUs

88.4700

Conversion factor

$33.4009

Medicare rate

$2,954.98

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

Payment rules and modifiers for 26553

26553 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26553

Toe-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)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 · 26553

Toe-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

26553 without 50 · national facility

$2,954.98

Toe-hand transfer

26553-50 · Bilateral: 150%

$4,432.47

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

26553 compared with similar codes

Compare codes · National

5 codes, side by side

  • 26553

    Toe-hand transfer46.97 wRVU

    Not priced

  • 26551

    Toe-to-hand transfer47.27 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

26551Toe-to-hand transfer
26551 is the great-toe-specific transfer. Use 26553 for a single transfer when the great-toe-specific service does not apply.
26554Toe-to-hand transfer
26554 describes a double toe-to-hand transfer; 26553 describes a single transfer.
26556Toe joint transfer
26556 transfers a toe joint to the hand, rather than transferring a whole toe as in 26553.
26550Thumb reconstruction
26550 reconstructs a thumb by pollicization of an existing digit; 26553 uses a toe transferred from the foot.

Codes related to 26553

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

Codes related to 26553
CodeHow it relatesNational office range
Same family
26551Toe-to-hand transferGreat-toe-specific transfer to the hand.No office rate
26554Toe-to-hand transferTransfer of two toes to the hand rather than one.No office rate
Used instead
26556Toe joint transferTransfers a toe joint to the hand rather than a whole toe.No office rate
26550Thumb reconstructionReconstructs a thumb by repositioning an existing digit instead of transferring a toe.No office rate

26553 billing questions

When should 26553 be chosen instead of 26551?

Use 26553 for a single toe transfer when the great-toe-specific service does not apply. Code 26551 identifies transfer of the great toe.

How does 26553 differ from 26554?

26553 represents one transferred toe; 26554 is for a double toe transfer. The operative report should support the number of toes transferred.

Is related postoperative care separately reported during the global period?

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

Can an assistant surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation.

How is a bilateral procedure handled?

For a bilateral procedure reported with modifier 50, CMS pays at 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 26553PPRRVU2026_Oct_nonQPP.csv, line 2,642 (RVU26D)

Open CMS sourceHow we calculate rates

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