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Billing code 26608: Metacarpal fractureMedicare rate & RVUs

Closed treatment of a metacarpal fracture with manipulation and percutaneous skeletal fixation, reported for each metacarpal bone treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.1K Medicare services in 2024

Medicare pays $464.27 for 26608 nationally in a facility.

Medicare rate · 26608

Metacarpal fracture

Swap in your local Medicare rate.

Work RVUs
5.41
Total RVUs
13.90
Global days
090

National rate · 2026

$464.27

Facility setting, before claim adjustments.

See every locality for 26608 → · 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 26608 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 26608 covers

This service treats a metacarpal fracture by manipulating the bone into alignment and stabilizing it with percutaneous skeletal fixation, such as pins placed through the skin. An orthopedic or hand surgeon typically performs the reduction and fixation in an operating room or other procedural setting. The fracture is treated without open exposure of the fracture site; when the surgeon exposes and treats the fracture directly, a different code family member is used.

Report this code for each metacarpal bone treated when both manipulation and percutaneous skeletal fixation are performed. The record should identify the fractured bone, describe the reduction and fixation method, and support the need for stabilization. The 90-day global period includes the day-before preoperative visit and 90 days of 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. Assistant-at-surgery payment requires documented medical necessity; 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 26608 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

26608 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$417.78
Alaska*Unavailable$554.68
ArizonaUnavailable$451.44
ArkansasUnavailable$411.99
AtlantaUnavailable$475.96
AustinUnavailable$474.93
BakersfieldUnavailable$477.52
Baltimore/Surr. CntysUnavailable$493.73
BeaumontUnavailable$439.43
BrazoriaUnavailable$455.63

26608 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
26608 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 26608 rate is calculated

Each of 26608’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 · 26608

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.41Practice expense 7.42Malpractice 1.07

13.9000 adjusted RVUs×$33.4009 conversion factor=$464.27

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

Payment rules and modifiers for 26608

26608 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 26608

Metacarpal fracture

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)0Not paid without supporting documentation.
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 · 26608

Metacarpal fracture

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

26608 without 51 · national facility

$464.27

Metacarpal fracture

26608-51 · Second procedure: 50%

$232.14

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

26608 compared with similar codes

Compare codes

26608 vs 26605 vs 26607 vs 26615: national Medicare rates

Swap in your local Medicare rate.

  • 26608
    Metacarpal fracture · 5.41 wRVU
    —
  • 26605
    Metacarpal fracture · 2.95 wRVU
    $376.43
  • 26607
    Metacarpal fracture · 5.34 wRVU
    —
  • 26615
    Metacarpal fracture · 6.89 wRVU
    —

How to choose

26605Metacarpal fracture
26605 covers manipulation without percutaneous skeletal fixation. Choose 26608 when fixation is also performed through the skin.
26607Metacarpal fracture
Both include manipulation and fixation, but 26607 uses external fixation; 26608 uses percutaneous skeletal fixation.
26615Metacarpal fracture
26615 is for open treatment of the metacarpal fracture. Choose 26608 when treatment uses manipulation and percutaneous fixation without open exposure.

Codes related to 26608

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

Codes related to 26608
CodeHow it relatesNational office range
Same family
26600Metacarpal fracture careMetacarpal fracture treatment without manipulation or percutaneous skeletal fixation.$299.84–$449.72
26605Metacarpal fractureIncludes manipulation but not the percutaneous skeletal fixation represented by this code.$330.24–$491.64
26607Metacarpal fractureMetacarpal fracture treatment with manipulation using external fixation.No office rate
Used instead
26615Metacarpal fractureUsed when the metacarpal fracture is treated through open exposure.No office rate

26608 billing questions

When should 26608 be selected instead of 26605?

Use 26608 when the metacarpal fracture is manipulated and stabilized with percutaneous skeletal fixation. Use 26605 for manipulation without that fixation.

How is this code different from 26607?

Both include manipulation and fixation, but 26608 represents percutaneous skeletal fixation. Code 26607 is for treatment using external fixation.

Is the code reported once per fracture or once per bone?

Report it for each metacarpal bone treated. The operative documentation should identify each bone receiving manipulation and percutaneous fixation.

Can modifier 50 be used for fractures in both hands?

No. Modifier 50 is inappropriate for this code under the CMS bilateral adjustment facts.

What postoperative care is included?

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

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 26608PPRRVU2026_Oct_nonQPP.csv, line 2,661 (RVU26D)

Open CMS sourceHow we calculate rates

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