$425.47–$618.80
Use 26641 for an isolated thumb carpometacarpal dislocation. Use 26645 when the thumb injury is a fracture-dislocation.
On this page
CMS RVU26D · Effective 2026-10-01
26641 Thumb dislocation Medicare reimbursement rates
Reports closed manipulation of a dislocated thumb carpometacarpal joint when reduction is performed under anesthesia and no fracture-dislocation is treated. Compare 26641 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 26641?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$412.21–$605.99
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $193.78 per service.
Facility setting
$339.05–$483.17
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $144.12 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 26641 pays more and less
109 payment localities
$412.21 to $605.99
Hand surgery
About 26641: Closed reduction of thumb carpometacarpal dislocation
Reports closed manipulation of a dislocated thumb carpometacarpal joint when reduction is performed under anesthesia and no fracture-dislocation is treated.
This service treats a dislocation at the base of the thumb, where the first metacarpal meets the wrist bones. The physician, commonly an orthopedic or hand surgeon, manipulates the joint back into position under anesthesia without open surgical exposure. It may be performed in an operating room or another setting equipped to provide the required anesthesia and manage the reduction.
Report the code for an isolated thumb carpometacarpal dislocation treated by closed manipulation under anesthesia, not for a fracture-dislocation or an open procedure. Documentation should identify the joint and side, establish the dislocation, and describe the reduction and anesthesia. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 26641
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.03 · 29%
- Practice expense (office) RVU9.16 · 65%
- Malpractice RVU0.86 · 6%
72
Medicare services in 2024 · #5127 by national volume
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.
26641 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$376.94–$552.48
This code addresses a thumb carpometacarpal dislocation; 26670 is for a carpometacarpal dislocation at another hand site.
No office rate
This code describes closed manipulation of a thumb joint dislocation under anesthesia. Code 26685 is for open treatment of a non-thumb carpometacarpal dislocation.
See how rates vary across the country
26641 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$412.21
$546.80
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $543.57 | 1 |
| AL | $418.57 | 1 |
| AR | $412.21 | 1 |
| AZ | $455.66 | 1 |
| CA | $487.61–$605.99 | 29 |
| CO | $484.19 | 1 |
| CT | $501.57 | 1 |
| DC | $534.26 | 1 |
| DE | $463.38 | 1 |
| FL | $470.27–$525.75 | 3 |
| GA | $441.75–$480.36 | 2 |
| GU | $499.10 | 1 |
| HI | $499.10 | 1 |
| IA | $425.96 | 1 |
| ID | $429.67 | 1 |
| IL | $458.84–$508.95 | 4 |
| IN | $432.18 | 1 |
| KS | $425.66 | 1 |
| KY | $432.88 | 1 |
| LA | $432.89–$455.14 | 2 |
| MA | $481.82–$531.00 | 2 |
| MD | $471.94–$534.26 | 3 |
| ME | $433.95–$455.93 | 2 |
| MI | $446.37–$478.28 | 2 |
| MN | $457.93 | 1 |
| MO | $426.31–$454.65 | 3 |
| MS | $419.26 | 1 |
| MT | $469.23 | 1 |
| NC | $438.41 | 1 |
| ND | $452.22 | 1 |
| NE | $427.86 | 1 |
| NH | $478.24 | 1 |
| NJ | $505.60–$528.67 | 2 |
| NM | $449.66 | 1 |
| NV | $464.79 | 1 |
| NY | $445.45–$560.34 | 5 |
| OH | $442.89 | 1 |
| OK | $430.14 | 1 |
| OR | $459.53–$498.04 | 2 |
| PA | $442.61–$489.79 | 2 |
| PR | $472.22 | 1 |
| RI | $478.83 | 1 |
| SC | $441.72 | 1 |
| SD | $450.21 | 1 |
| TN | $428.14 | 1 |
| TX | $439.71–$484.02 | 8 |
| UT | $448.00 | 1 |
| VA | $455.64–$534.26 | 2 |
| VI | $472.22 | 1 |
| VT | $452.03 | 1 |
| WA | $480.38–$540.21 | 2 |
| WI | $436.56 | 1 |
| WV | $441.58 | 1 |
| WY | $461.81 | 1 |
Compare 26641 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $418.57 | Facility $344.05 |
| Alaska* | Office $543.57 | Facility $452.87 |
| Arizona | Office $455.66 | Facility $373.13 |
| Arkansas | Office $412.21 | Facility $339.05 |
| Atlanta | Office $480.36 | Facility $393.82 |
| Austin | Office $484.02 | Facility $393.91 |
| Bakersfield | Office $489.98 | Facility $396.63 |
| Baltimore/Surr. Cntys | Office $500.58 | Facility $409.19 |
| Beaumont | Office $439.71 | Facility $362.20 |
| Brazoria | Office $461.29 | Facility $376.88 |
| Chicago | Office $508.95 | Facility $423.36 |
| Chico | Office $487.61 | Facility $394.27 |
| Colorado | Office $484.19 | Facility $393.56 |
| Connecticut | Office $501.57 | Facility $409.83 |
| Dallas | Office $465.19 | Facility $380.36 |
| Dc + Md/Va Suburbs | Office $534.26 | Facility $433.92 |
| Delaware | Office $463.38 | Facility $379.23 |
| Detroit | Office $478.28 | Facility $396.09 |
| East St. Louis | Office $473.93 | Facility $395.57 |
| El Centro | Office $487.76 | Facility $394.41 |
| Fort Lauderdale | Office $496.47 | Facility $410.19 |
| Fort Worth | Office $462.51 | Facility $378.53 |
| Fresno | Office $487.61 | Facility $394.27 |
| Galveston | Office $463.28 | Facility $378.70 |
| Hanford-Corcoran | Office $487.61 | Facility $394.27 |
| Hawaii, Guam | Office $499.10 | Facility $402.26 |
| Houston | Office $479.02 | Facility $394.44 |
| Idaho | Office $429.67 | Facility $351.31 |
| Indiana | Office $432.18 | Facility $353.23 |
| Iowa | Office $425.96 | Facility $348.02 |
| Kansas | Office $425.66 | Facility $348.67 |
| Kentucky | Office $432.88 | Facility $357.16 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $521.14 | Facility $420.38 |
| Madera | Office $487.61 | Facility $394.27 |
| Manhattan | Office $544.29 | Facility $445.32 |
| Merced | Office $487.61 | Facility $394.27 |
| Metropolitan Boston | Office $531.00 | Facility $429.30 |
| Metropolitan Kansas City | Office $449.96 | Facility $369.98 |
| Metropolitan Philadelphia | Office $489.79 | Facility $401.13 |
| Metropolitan St. Louis | Office $454.65 | Facility $373.57 |
| Miami | Office $525.75 | Facility $437.08 |
| Minnesota | Office $457.93 | Facility $370.29 |
| Mississippi | Office $419.26 | Facility $345.92 |
| Modesto | Office $487.61 | Facility $394.27 |
| Montana** | Office $469.23 | Facility $384.05 |
| Napa | Office $560.92 | Facility $448.67 |
| Nebraska | Office $427.86 | Facility $349.24 |
| Nevada** | Office $464.79 | Facility $379.53 |
| New Hampshire | Office $478.24 | Facility $389.57 |
| New Mexico | Office $449.66 | Facility $371.56 |
| New Orleans | Office $455.14 | Facility $374.99 |
| North Carolina | Office $438.41 | Facility $358.95 |
| North Dakota** | Office $452.22 | Facility $367.05 |
| Northern Nj | Office $528.67 | Facility $429.87 |
| Nyc Suburbs/Long Island | Office $560.34 | Facility $459.07 |
| Ohio | Office $442.89 | Facility $365.13 |
| Oklahoma | Office $430.14 | Facility $354.08 |
| Oxnard-Thousand Oaks-Ventura | Office $517.91 | Facility $417.23 |
| Portland | Office $498.04 | Facility $403.42 |
| Poughkpsie/N Nyc Suburbs | Office $510.44 | Facility $417.17 |
| Puerto Rico | Office $472.22 | Facility $386.11 |
| Queens | Office $546.28 | Facility $445.60 |
| Redding | Office $487.61 | Facility $394.27 |
| Rest Of California | Office $487.61 | Facility $394.27 |
| Rest Of Florida | Office $470.27 | Facility $388.84 |
| Rest Of Georgia | Office $441.75 | Facility $365.78 |
| Rest Of Illinois | Office $458.84 | Facility $381.07 |
| Rest Of Louisiana | Office $432.89 | Facility $357.51 |
| Rest Of Maine | Office $433.95 | Facility $355.59 |
| Rest Of Maryland | Office $471.94 | Facility $385.75 |
| Rest Of Massachusetts | Office $481.82 | Facility $392.13 |
| Rest Of Michigan | Office $446.37 | Facility $368.61 |
| Rest Of Missouri | Office $426.31 | Facility $352.90 |
| Rest Of New Jersey | Office $505.60 | Facility $412.59 |
| Rest Of New York | Office $445.45 | Facility $364.54 |
| Rest Of Oregon | Office $459.53 | Facility $374.70 |
| Rest Of Pennsylvania | Office $442.61 | Facility $364.43 |
| Rest Of Texas | Office $450.89 | Facility $370.06 |
| Rest Of Washington | Office $480.38 | Facility $390.70 |
| Rhode Island | Office $478.83 | Facility $390.85 |
| Riverside-San Bernardino-Ontario | Office $496.85 | Facility $403.51 |
| Sacramento-Roseville-Folsom | Office $510.67 | Facility $411.61 |
| Salinas | Office $508.77 | Facility $410.06 |
| San Diego-Chula Vista-Carlsbad | Office $520.13 | Facility $418.27 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $591.97 | Facility $471.88 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $590.99 | Facility $470.90 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $605.99 | Facility $483.17 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $602.00 | Facility $479.18 |
| San Luis Obispo-Paso Robles | Office $500.77 | Facility $403.76 |
| Santa Cruz-Watsonville | Office $524.56 | Facility $421.08 |
| Santa Maria-Santa Barbara | Office $510.51 | Facility $411.20 |
| Santa Rosa-Petaluma | Office $529.75 | Facility $425.16 |
| Seattle (King Cnty) | Office $540.21 | Facility $435.70 |
| South Carolina | Office $441.72 | Facility $363.02 |
| South Dakota** | Office $450.21 | Facility $365.04 |
| Southern Maine | Office $455.93 | Facility $371.52 |
| Stockton | Office $487.61 | Facility $394.27 |
| Suburban Chicago | Office $500.66 | Facility $413.19 |
| Tennessee | Office $428.14 | Facility $350.72 |
| Utah | Office $448.00 | Facility $367.93 |
| Vallejo | Office $559.52 | Facility $447.26 |
| Vermont | Office $452.03 | Facility $367.71 |
| Virgin Islands | Office $472.22 | Facility $386.11 |
| Virginia | Office $455.64 | Facility $371.91 |
| Visalia | Office $487.61 | Facility $394.27 |
| West Virginia | Office $441.58 | Facility $367.57 |
| Wisconsin | Office $436.56 | Facility $354.96 |
| Wyoming** | Office $461.81 | Facility $376.64 |
| Yuba City | Office $487.61 | Facility $394.27 |
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26641 billing questions
How does this differ from code 26645?
This code is for an isolated thumb carpometacarpal dislocation. Code 26645 is for a thumb carpometacarpal fracture-dislocation, where a fracture accompanies the dislocation.
Can routine follow-up be billed separately?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
How is bilateral treatment reported?
Use modifier 50 for bilateral treatment; CMS pays the bilateral procedure at 150%.
When may an assistant-at-surgery be paid?
Payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
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 the other procedure or 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,66026607,,Treat metacarpal fracture,A,,5.34,8.41,NA,8.41,,1.14,14.89,14.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66126608,,Treat metacarpal fracture,A,,5.41,7.42,NA,7.42,,1.07,13.90,13.90,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66226615,,Treat metacarpal fracture,A,,6.89,8.18,NA,8.18,,1.33,16.40,16.40,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66326641,,Treat thumb dislocation,A,,4.03,9.16,,6.61,,0.86,14.05,11.50,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66426645,,Treat thumb fracture,A,,4.47,9.05,,6.30,,0.96,14.48,11.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66526650,,Treat thumb fracture,A,,5.22,7.83,NA,7.83,,1.04,14.09,14.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,66626665,,Treat thumb fracture,A,,7.74,8.24,NA,8.24,,1.32,17.30,17.30,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00