Billing code 26600: Metacarpal fracture careMedicare rate & RVUs
Closed treatment of one metacarpal fracture without manipulation, typically used when the treating clinician immobilizes the fracture without repositioning it.
Medicare pays $341.69 for 26600 nationally in the office and $300.61 in a hospital or facility. Local office rates run $299.84–$449.72.
Medicare rate · 26600
Metacarpal fracture care
Swap in your local Medicare rate.
- Work RVUs
- 2.54
- Total RVUs
- 10.23
- Global days
- 090
National rate · 2026
$341.69
Office setting, before claim adjustments.
See every locality for 26600 → · 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
What 26600 covers
This code describes closed care for a fracture of one metacarpal when the clinician does not manipulate the bone to reduce or reposition it. Orthopedic and hand surgeons commonly provide this care, as may other clinicians who manage acute hand fractures, in an office, emergency department, or facility setting. Treatment may include stabilizing the hand with an appropriate splint or cast and arranging fracture follow-up.
Select this code when documentation supports treatment of one metacarpal fracture without manipulation; use the multiple-fracture code family when more than one metacarpal is treated. Record the injured bone, fracture findings, treatment plan, and immobilization. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Medicare does not pay an assistant at surgery for this service; 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 26600 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$299.84 to $449.72
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $304.53 | $268.58 |
| Alaska* | $392.39 | $348.64 |
| Arizona | $331.88 | $292.07 |
| Arkansas | $299.84 | $264.55 |
| Atlanta | $349.08 | $307.34 |
| Austin | $353.94 | $310.48 |
| Bakersfield | $359.99 | $314.96 |
| Baltimore/Surr. Cntys | $364.48 | $320.40 |
| Beaumont | $318.89 | $281.50 |
| Brazoria | $336.60 | $295.89 |
| Chicago | $364.68 | $323.39 |
| Chico | $358.63 | $313.60 |
| Colorado | $354.52 | $310.80 |
| Connecticut | $365.34 | $321.10 |
| Dallas | $339.17 | $298.25 |
| Dc + Md/Va Suburbs | $390.93 | $342.53 |
| Delaware | $337.58 | $296.99 |
| Detroit | $344.50 | $304.86 |
| East St. Louis | $339.05 | $301.25 |
| El Centro | $358.71 | $313.68 |
| Fort Lauderdale | $358.04 | $316.42 |
| Fort Worth | $336.98 | $296.47 |
| Fresno | $358.63 | $313.60 |
| Galveston | $337.87 | $297.08 |
| Hanford-Corcoran | $358.63 | $313.60 |
| Hawaii, Guam | $367.75 | $321.04 |
| Houston | $346.84 | $306.04 |
| Idaho | $313.83 | $276.03 |
| Indiana | $315.72 | $277.64 |
| Iowa | $311.38 | $273.79 |
| Kansas | $310.49 | $273.35 |
| Kentucky | $313.61 | $277.08 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $383.68 | $335.08 |
| Madera | $358.63 | $313.60 |
| Manhattan | $395.67 | $347.93 |
| Merced | $358.63 | $313.60 |
| Metropolitan Boston | $390.02 | $340.97 |
| Metropolitan Kansas City | $326.65 | $288.07 |
| Metropolitan Philadelphia | $356.24 | $313.47 |
| Metropolitan St. Louis | $330.18 | $291.07 |
| Miami | $376.58 | $333.81 |
| Minnesota | $337.14 | $294.87 |
| Mississippi | $303.99 | $268.62 |
| Modesto | $358.63 | $313.60 |
| Montana** | $341.66 | $300.58 |
| Napa | $415.46 | $361.31 |
| Nebraska | $312.99 | $275.07 |
| Nevada** | $339.20 | $298.07 |
| New Hampshire | $349.51 | $306.74 |
| New Mexico | $325.02 | $287.35 |
| New Orleans | $329.73 | $291.07 |
| North Carolina | $319.67 | $281.34 |
| North Dakota** | $331.97 | $290.89 |
| Northern Nj | $386.63 | $338.97 |
| Nyc Suburbs/Long Island | $406.60 | $357.75 |
| Ohio | $320.90 | $283.39 |
| Oklahoma | $312.31 | $275.62 |
| Oxnard-Thousand Oaks-Ventura | $381.67 | $333.10 |
| Portland | $365.55 | $319.91 |
| Poughkpsie/N Nyc Suburbs | $371.79 | $326.81 |
| Puerto Rico | $344.09 | $302.56 |
| Queens | $398.12 | $349.56 |
| Redding | $358.63 | $313.60 |
| Rest Of California | $358.63 | $313.60 |
| Rest Of Florida | $339.34 | $300.07 |
| Rest Of Georgia | $318.86 | $282.21 |
| Rest Of Illinois | $329.98 | $292.47 |
| Rest Of Louisiana | $313.35 | $276.99 |
| Rest Of Maine | $316.27 | $278.47 |
| Rest Of Maryland | $344.08 | $302.51 |
| Rest Of Massachusetts | $352.47 | $309.21 |
| Rest Of Michigan | $322.88 | $285.37 |
| Rest Of Missouri | $308.08 | $272.66 |
| Rest Of New Jersey | $368.80 | $323.93 |
| Rest Of New York | $324.81 | $285.78 |
| Rest Of Oregon | $335.87 | $294.95 |
| Rest Of Pennsylvania | $321.07 | $283.36 |
| Rest Of Texas | $327.84 | $288.85 |
| Rest Of Washington | $351.63 | $308.37 |
| Rhode Island | $349.47 | $307.03 |
| Riverside-San Bernardino-Ontario | $363.90 | $318.87 |
| Sacramento-Roseville-Folsom | $376.35 | $328.57 |
| Salinas | $374.96 | $327.35 |
| San Diego-Chula Vista-Carlsbad | $383.88 | $334.74 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $439.50 | $381.57 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $438.94 | $381.01 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $449.72 | $390.48 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $447.45 | $388.21 |
| San Luis Obispo-Paso Robles | $368.97 | $322.17 |
| Santa Cruz-Watsonville | $387.58 | $337.67 |
| Santa Maria-Santa Barbara | $376.39 | $328.49 |
| Santa Rosa-Petaluma | $391.47 | $341.02 |
| Seattle (King Cnty) | $397.53 | $347.12 |
| South Carolina | $320.96 | $283.00 |
| South Dakota** | $330.82 | $289.74 |
| Southern Maine | $333.49 | $292.77 |
| Stockton | $358.63 | $313.60 |
| Suburban Chicago | $361.41 | $319.22 |
| Tennessee | $312.23 | $274.88 |
| Utah | $325.59 | $286.97 |
| Vallejo | $414.66 | $360.51 |
| Vermont | $331.20 | $290.53 |
| Virgin Islands | $344.09 | $302.56 |
| Virginia | $332.79 | $292.41 |
| Visalia | $358.63 | $313.60 |
| West Virginia | $317.24 | $281.54 |
| Wisconsin | $320.27 | $280.91 |
| Wyoming** | $337.44 | $296.35 |
| Yuba City | $358.63 | $313.60 |
26600 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$299.84
$404.18
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $392.39 | 1 |
| AL | $304.53 | 1 |
| AR | $299.84 | 1 |
| AZ | $331.88 | 1 |
| CA | $358.63–$449.72 | 29 |
| CO | $354.52 | 1 |
| CT | $365.34 | 1 |
| DC | $390.93 | 1 |
| DE | $337.58 | 1 |
| FL | $339.34–$376.58 | 3 |
| GA | $318.86–$349.08 | 2 |
| GU | $367.75 | 1 |
| HI | $367.75 | 1 |
| IA | $311.38 | 1 |
| ID | $313.83 | 1 |
| IL | $329.98–$364.68 | 4 |
| IN | $315.72 | 1 |
| KS | $310.49 | 1 |
| KY | $313.61 | 1 |
| LA | $313.35–$329.73 | 2 |
| MA | $352.47–$390.02 | 2 |
| MD | $344.08–$390.93 | 3 |
| ME | $316.27–$333.49 | 2 |
| MI | $322.88–$344.50 | 2 |
| MN | $337.14 | 1 |
| MO | $308.08–$330.18 | 3 |
| MS | $303.99 | 1 |
| MT | $341.66 | 1 |
| NC | $319.67 | 1 |
| ND | $331.97 | 1 |
| NE | $312.99 | 1 |
| NH | $349.51 | 1 |
| NJ | $368.80–$386.63 | 2 |
| NM | $325.02 | 1 |
| NV | $339.20 | 1 |
| NY | $324.81–$406.60 | 5 |
| OH | $320.90 | 1 |
| OK | $312.31 | 1 |
| OR | $335.87–$365.55 | 2 |
| PA | $321.07–$356.24 | 2 |
| PR | $344.09 | 1 |
| RI | $349.47 | 1 |
| SC | $320.96 | 1 |
| SD | $330.82 | 1 |
| TN | $312.23 | 1 |
| TX | $318.89–$353.94 | 8 |
| UT | $325.59 | 1 |
| VA | $332.79–$390.93 | 2 |
| VI | $344.09 | 1 |
| VT | $331.20 | 1 |
| WA | $351.63–$397.53 | 2 |
| WI | $320.27 | 1 |
| WV | $317.24 | 1 |
| WY | $337.44 | 1 |
How the 26600 rate is calculated
Each of 26600’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 · 26600
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.54Practice expense 7.20Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 26600
26600 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 26600
Metacarpal fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 26600
Metacarpal fracture care
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
26600 without 51 · national office
$341.69
Metacarpal fracture care
26600-51 · Second procedure: 50%
$170.85
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%).
26600 compared with similar codes
Compare codes
26600 vs 26605 vs 26607 vs 26608 vs 26615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 26605Metacarpal fracture
- Both concern treatment of a single metacarpal fracture; 26605 is selected when the fracture is manipulated, while 26600 is for treatment without manipulation.
- 26607Metacarpal fracture
- 26607 is used for multiple metacarpal fractures treated without manipulation; 26600 is for a single metacarpal fracture.
- 26608Metacarpal fracture
- 26608 addresses multiple metacarpal fractures treated with manipulation. 26600 is for a single fracture treated without manipulation.
- 26615Metacarpal fracture
- 26615 describes open treatment of a metacarpal fracture. Choose 26600 for closed treatment of one bone without manipulation.
26600 billing questions
When should 26600 be chosen over 26605?
Use 26600 when one metacarpal fracture is treated without manipulation. Use 26605 when the clinician manipulates the fracture.
How does 26600 differ from 26607?
26600 is for treatment of a single metacarpal fracture. The 26607 family addresses multiple metacarpal fractures treated without manipulation.
Can the initial cast or splint be billed separately?
Routine initial immobilization associated with the fracture treatment is generally included in the fracture-care service. Document the immobilization and treatment plan.
Can modifier 50 be used for fractures in both hands?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 26600?
Document the metacarpal involved, the fracture diagnosis and findings, that one bone is being treated, and that no manipulation was performed.
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
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