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Billing code 26556: Toe joint transferMedicare rate & RVUs

Reports microsurgical transfer of a toe joint to the hand when reconstruction requires a vascularized joint rather than transfer of an entire toe.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $3,079.90 for 26556 nationally in a facility.

Medicare rate · 26556

Toe joint transfer

Swap in your local Medicare rate.

Work RVUs
48.51
Total RVUs
92.21
Global days
090

National rate · 2026

$3,079.90

Facility setting, before claim adjustments.

See every locality for 26556 → · 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 26556 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 26556 covers

This procedure moves a toe joint to the hand to reconstruct a finger or other hand joint, using microsurgical vascular anastomosis to establish blood supply. A hand or microsurgery specialist may perform it for selected reconstructive needs, such as joint loss after trauma or a congenital difference. The operation involves the donor toe joint and the recipient hand site; it is distinct from transferring a whole toe or toes.

Select the code when the operative report supports transfer of the joint itself, not merely a toe-digit transfer or local joint reconstruction. Document the donor and recipient sites, the reconstructive purpose, and the microsurgical work. CMS 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. Modifier 50 is inappropriate for this code. 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 26556 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

26556 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,790.42
Alaska*Unavailable$3,806.88
ArizonaUnavailable$2,995.51
ArkansasUnavailable$2,754.94
AtlantaUnavailable$3,172.19
AustinUnavailable$3,108.22
BakersfieldUnavailable$3,082.12
Baltimore/Surr. CntysUnavailable$3,269.18
BeaumontUnavailable$2,955.11
BrazoriaUnavailable$3,006.64

26556 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.

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View every state and territory as a table
26556 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 26556 rate is calculated

Each of 26556’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 · 26556

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 48.51Practice expense 33.33Malpractice 10.37

92.2100 adjusted RVUs×$33.4009 conversion factor=$3,079.90

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

Payment rules and modifiers for 26556

26556 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26556

Toe joint 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)0The 150% bilateral adjustment doesn’t apply.
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 · 26556

Toe joint 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.

  • 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

26556 without 51 · national facility

$3,079.90

Toe joint transfer

26556-51 · Second procedure: 50%

$1,539.95

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

26556 compared with similar codes

Compare codes

26556 vs 26551 vs 26553 vs 26554: national Medicare rates

Swap in your local Medicare rate.

  • 26556
    Toe joint transfer · 48.51 wRVU
    —
  • 26551
    Toe-to-hand transfer · 47.27 wRVU
    —
  • 26553
    Toe-hand transfer · 46.97 wRVU
    —
  • 26554
    Toe-to-hand transfer · 55.58 wRVU
    —

How to choose

26551Toe-to-hand transfer
26551 describes transfer of a great toe to the hand. Choose 26556 when the transferred structure is a toe joint, not the whole toe.
26553Toe-hand transfer
26553 describes a single toe transfer to the hand. 26556 represents transfer of a toe joint for hand reconstruction.
26554Toe-to-hand transfer
26554 describes transfer of two toes to the hand. 26556 is selected for toe-joint transfer rather than a double-toe transfer.

Codes related to 26556

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

Codes related to 26556
CodeHow it relatesNational office range
Used instead
26551Toe-to-hand transferWhole great-toe transfer to the hand, rather than transfer of a toe joint.No office rate
26553Toe-hand transferSingle toe transfer to the hand when the operation transfers a toe digit.No office rate
26554Toe-to-hand transferDouble toe transfer to the hand, rather than an isolated toe joint.No office rate

26556 billing questions

How is this different from a whole-toe transfer code?

Use 26556 when the transferred structure is a toe joint for hand reconstruction. Codes 26551, 26553, and 26554 describe transfer of toe digit tissue rather than an isolated toe joint.

What operative details support reporting 26556?

The record should identify the toe joint moved to the hand, the donor and recipient sites, the reconstructive indication, and the microsurgical vascular work.

Is the preoperative visit or routine postoperative care separately included?

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

Can modifier 50 be used for bilateral toe joint transfers?

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

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 reduced to 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 26556PPRRVU2026_Oct_nonQPP.csv, line 2,645 (RVU26D)

Open CMS sourceHow we calculate rates

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